TY - JOUR
T1 - Prognostic value of FEV1/FEV6 in elderly people
AU - Sorino, Claudio
AU - Sherrill, Duane
AU - Guerra, Stefano
AU - Enright, Paul
AU - Pedone, Claudio
AU - Augugliaro, Giuseppe
AU - Scichilone, Nicola
AU - Battaglia, Salvatore
AU - Antonelli-Incalzi, Raffaele
AU - Bellia, Vincenzo
PY - 2011/3/1
Y1 - 2011/3/1
N2 - Background: The ratio of forced expiratory volume in 1s and forced expiratory volume in 6s (FEV1/FEV6) has been proposed as an alternative for FEV1/forced vital capacity (FVC) to diagnose obstructive diseases with less effort during spirometry; however, its prognostic value is unknown. We evaluated whether FEV1/FEV6 is a significant predictor of mortality in elderly subjects and compared its prognostic value with that of FEV1/FVC and FEV1. Methods: One thousand nine hundred and seventy-one subjects, aged >65years, participated in the population-based SA.R.A. study. During the baseline exam, a multidimensional assessment included spirometry. Vital status was determined during 6years of follow-up. Association of all-cause, cardio-pulmonary (CP) and non-CP mortality with a low FEV1/FEV6, FEV1/FVC and FEV1 was evaluated. Results: Among subjects with both survival data and acceptable spirometry including FEV6, all-cause unadjusted mortality rates were 7·00 and 2·46 per 100 person-years in subjects with FEV1/FEV6 less than and greater than or equal to lower limit of normal (LLN), respectively (mortality rate ratio: 2·84, 95%CI: 2·12-3·84). After adjustment for age, gender, FVC, smoke exposure and main comorbidities, the risk of all-cause mortality remained significantly increased in subjects with FEV1/FEV6<LLN [hazard ratio (HR): 1·87, 95%CI: 1·35-2·58] as well as in subjects with FEV1/FVC<LLN (HR: 2·01, 95%CI: 1·51-2·90) and FEV1<LLN (HR: 2·17, 95%CI: 1·32-3·57). Similar results were found for CP mortality, but not for non-CP mortality. Conclusions: A low FEV1/FEV6 is a significant predictor of mortality in older individuals. Its prognostic value is comparable to that of a low FEV1/FVC and FEV1.
AB - Background: The ratio of forced expiratory volume in 1s and forced expiratory volume in 6s (FEV1/FEV6) has been proposed as an alternative for FEV1/forced vital capacity (FVC) to diagnose obstructive diseases with less effort during spirometry; however, its prognostic value is unknown. We evaluated whether FEV1/FEV6 is a significant predictor of mortality in elderly subjects and compared its prognostic value with that of FEV1/FVC and FEV1. Methods: One thousand nine hundred and seventy-one subjects, aged >65years, participated in the population-based SA.R.A. study. During the baseline exam, a multidimensional assessment included spirometry. Vital status was determined during 6years of follow-up. Association of all-cause, cardio-pulmonary (CP) and non-CP mortality with a low FEV1/FEV6, FEV1/FVC and FEV1 was evaluated. Results: Among subjects with both survival data and acceptable spirometry including FEV6, all-cause unadjusted mortality rates were 7·00 and 2·46 per 100 person-years in subjects with FEV1/FEV6 less than and greater than or equal to lower limit of normal (LLN), respectively (mortality rate ratio: 2·84, 95%CI: 2·12-3·84). After adjustment for age, gender, FVC, smoke exposure and main comorbidities, the risk of all-cause mortality remained significantly increased in subjects with FEV1/FEV6<LLN [hazard ratio (HR): 1·87, 95%CI: 1·35-2·58] as well as in subjects with FEV1/FVC<LLN (HR: 2·01, 95%CI: 1·51-2·90) and FEV1<LLN (HR: 2·17, 95%CI: 1·32-3·57). Similar results were found for CP mortality, but not for non-CP mortality. Conclusions: A low FEV1/FEV6 is a significant predictor of mortality in older individuals. Its prognostic value is comparable to that of a low FEV1/FVC and FEV1.
KW - Aged
KW - Forced expiratory volume
KW - Obstructive pulmonary diseases
KW - Respiratory function tests
KW - Spirometry
KW - Vital capacity
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U2 - 10.1111/j.1475-097X.2010.00984.x
DO - 10.1111/j.1475-097X.2010.00984.x
M3 - Article
C2 - 20969726
AN - SCOPUS:79851493432
VL - 31
SP - 101
EP - 107
JO - Clinical Physiology and Functional Imaging
JF - Clinical Physiology and Functional Imaging
SN - 1475-0961
IS - 2
ER -