Trajectory and mortality of preserved ratio impaired spirometry: the Rotterdam Study

Preserved ratio impaired spirometry (PRISm) is a heterogeneous condition but its course and disease progression remain to be elucidated. We aimed to examine its prevalence, trajectories and prognosis in the general population. In the Rotterdam Study (population-based prospective cohort) we examined prevalence, trajectories and prognosis of subjects with normal spirometry (controls; forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ≥0.7, FEV1 ≥80%), PRISm (FEV1/FVC ≥0.7, FEV1 <80%) and chronic obstructive pulmonary disease (COPD) (FEV1/FVC <0.7) at two study visits. Hazard ratios with 95% confidence intervals for mortality (until December 30, 2018) were adjusted for age, sex, body mass index, current smoking and pack-years. Of 5487 subjects (age 69.1±8.9 years; 7.1% PRISm), 1603 were re-examined after 4.5 years. Of the re-examined PRISm subjects, 15.7% transitioned to normal spirometry and 49.4% to COPD. Median lung function decline was highest in subjects with incident PRISm (FEV1 –92.8 mL·year–1, interquartile range (IQR) –131.9––65.8 mL·year–1; FVC –93.3 mL·year–1, IQR –159.8––49.1 mL·year–1), but similar in persistent PRISm (FEV1 –30.2 mL·year–1, IQR –67.9––7.5 mL·year–1; FVC –20.1 mL·year–1, IQR –47.7–21.7 mL·year–1) and persistent c...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung structure and function Original Articles: Lung structure and function Source Type: research