1. Incidence of chronic obstructive pulmonary disease in a cohort of young adults according to the presence of chronic cough and phlegm
- Author
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Cecilie Svanes, Roberto de Marco, Nino Künzli, Deborah Jarvis, Peter Burney, Paul Vermeire, Angelo Corsico, Ursula Ackermann-Liebrich, Bénédicte Leynaert, Françoise Neukirch, Joachim Heinrich, Jan P. Schouten, Simone Accordini, Jordi Sunyer, Josep M. Antó, Isa Cerveri, Matthias Wjst, Thorarinn Gislason, Christer Janson, and Susan Chinn
- Subjects
chronic cough and phlegm, chronic obstructive pulmonary disease, incidence, epidemiology ,Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Chronic bronchitis ,CHRONIC MUCUS HYPERSECRETION ,RESPIRATORY-HEALTH-SURVEY ,Critical Care and Intensive Care Medicine ,Rate ratio ,chronic obstructive pulmonary disease ,Cohort Studies ,Pulmonary Disease, Chronic Obstructive ,FEV1/FVC ratio ,Internal medicine ,LUNG-FUNCTION DECLINE ,Humans ,Medicine ,COPD ,Prospective cohort study ,POPULATION ,Asthma ,business.industry ,chronic cough and phlegm ,MORTALITY ,medicine.disease ,respiratory tract diseases ,COMMUNITY ,Mucus ,Chronic cough ,Dyspnea ,CHRONIC-BRONCHITIS ,Cough ,GOLD CLASSIFICATION ,Chronic Disease ,Cohort ,Physical therapy ,incidence ,RISK-FACTORS ,Female ,epidemiology ,medicine.symptom ,business - Abstract
Rationale: The few prospective studies aimed at assessing the incidence of chronic obstructive pulmonary disease (COPD) in relation to the presence of chronic cough/phlegm have produced contrasting results.Objectives: To assess the incidence of COPD in a cohort of young adults and to test whether chronic cough/phlegm and dyspnea are independent predictors of COPD. Methods: An international cohort of 5,002 subjects without asthma (ages 20-44 yr) with normal lung function (FEV1/FVC ratio >= 70%) from 12 countries was followed from 1991-2002 in the frame of the European Community Respiratory Health Survey II. Incident cases of COPD were those who had an FEV1/FVC ratio less than 70% at the end of the follow-up, but did not report having had a doctor diagnose asthma during the follow-up.Main Results: The incidence rate of COPD was 2.8 cases/1,000/yr (95% confidence interval [CI], 2.3-3.3). Chronic cough/phlegm was an independent and statistically significant predictor of COPD (incidence rate ratio [IRR], 1.85; 95% Cl, 1.17-2.93) after adjusting for smoking habits and other potential confounders, whereas dyspnea was not associated with the disease (IRR = 0.98; 95% Cl, 0.64-1.50). Subjects who reported chronic cough/phlegm both at baseline and at the follow-up had a nearly threefold-increased risk of developing COPD with respect to asymptomatic subjects (IRR = 2.88; 95% Cl, 1.44-5.79).Conclusions: The incidence of COPD is substantial even in young adults. The presence of chronic cough/phlegm identifies a subgroup of subjects with a high risk of developing COPD, independently of smoking habits.
- Published
- 2007