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Importance of Early COPD in Young Adults for Development of Clinical COPD: Findings from the Copenhagen General Population Study.
- Source :
- American Journal of Respiratory & Critical Care Medicine; 5/15/2021, Vol. 203 Issue 10, p1245-E8, 20p
- Publication Year :
- 2021
-
Abstract
- Rationale: Individuals who will develop chronic obstructive pulmonary disease (COPD) could be identified at an early age before clinical manifestations appear. Objectives: We investigated risk of clinical COPD 10 years later in young adults from the general population with and without early COPD with a focus on smoking exposure. Methods: We included 14,870 individuals aged 20-100 years from the Copenhagen General Population Study with spirometry 10 years apart. Early COPD was defined as baseline FEV1/FVC less than the lower limit of normal in individuals aged <50 years. Outcomes included clinical COPD at final examination 10 years later (chronic respiratory symptoms with FEV1/FVC <0.70 and FEV1 <80% predicted) and acute exacerbation hospitalizations during follow-up. Measurements and Main Results: Among 5,497 individuals aged <50 years at baseline with FEV1/FVC ≥0.70, 104 (3%) developed clinical COPD 10 years later; 4% of smokers with ≥10 pack-years had early COPD; 3% of smokers with <10 pack-years had early COPD; and 2% of never-smokers had early COPD. Among smokers with ≥10 pack-years, 24% developed clinical COPD in those with early COPD versus 4% in those without early COPD. Corresponding numbers were 10% and 1% in smokers with <10 pack-years and 3% and <1% in never-smokers, respectively. Among individuals with early COPD, odds ratios for clinical COPD 10 years later were 7.77 (95% confidence interval [CI], 4.10-14.7) in smokers with ≥10 pack-years and 8.56 (95% CI, 4.92-14.9) in all smokers, whereas hazard ratios for acute exacerbation hospitalizations were 4.16 (95% CI, 1.66-10.5) and 4.33 (95% CI, 1.89-9.93), respectively. Results were validated in the Copenhagen City Heart Study. Conclusions: Depending on amount of smoking exposure, <24% of young adults in the general population with early COPD develop clinical COPD 10 years later. A smoking exposure threshold for early COPD should be reconsidered, as younger individuals are less represented in those with high smoking exposure. [ABSTRACT FROM AUTHOR]
- Subjects :
- EARLY diagnosis
OBSTRUCTIVE lung disease diagnosis
OBSTRUCTIVE lung disease treatment
OBSTRUCTIVE lung diseases patients
HOSPITAL care
RESEARCH
AGE distribution
RESEARCH methodology
RESPIRATORY measurements
MEDICAL cooperation
EVALUATION research
COMPARATIVE studies
OBSTRUCTIVE lung diseases
FORCED expiratory volume
QUESTIONNAIRES
SPIROMETRY
SMOKING
LONGITUDINAL method
Subjects
Details
- Language :
- English
- ISSN :
- 1073449X
- Volume :
- 203
- Issue :
- 10
- Database :
- Complementary Index
- Journal :
- American Journal of Respiratory & Critical Care Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 150421980
- Full Text :
- https://doi.org/10.1164/rccm.202003-0532OC