A Risk Prediction Model for Mortality Among Smokers in the COPDGene® Study.
COPD Genetic Epidemiology study
COPDGene
PRISm
copd
preserved ratio-impaired spirometry
risk score
spirometry
Journal
Chronic obstructive pulmonary diseases (Miami, Fla.)
ISSN: 2372-952X
Titre abrégé: Chronic Obstr Pulm Dis
Pays: United States
ID NLM: 101635411
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
pubmed:
3
9
2020
medline:
3
9
2020
entrez:
3
9
2020
Statut:
ppublish
Résumé
Risk factor identification is a proven strategy in advancing treatments and preventive therapy for many chronic conditions. Quantifying the impact of those risk factors on health outcomes can consolidate and focus efforts on individuals with specific high-risk profiles. Using multiple risk factors and longitudinal outcomes in 2 independent cohorts, we developed and validated a risk score model to predict mortality in current and former cigarette smokers. We obtained extensive data on current and former smokers from the COPD Genetic Epidemiology (COPDGene Of 9867 COPDGene participants with standard baseline data, 17.6% died over 10 years of follow-up, and 9074 of these participants had the full set of baseline predictors (standard plus 6-minute walk distance and computed tomography variables) available for full model fits. The average age of participants in the cohort was 60 for both men and women, and the average predicted 10-year mortality risk was 18% for women and 25% for men. Model time-integrated area under the receiver operating characteristic curve statistics demonstrated good predictive model accuracy (0.797 average), validated in the external cohort (0.756 average). Risk of mortality was impacted most by 6-minute walk distance, forced expiratory volume in 1 second and age, for both men and women. Current and former smokers exhibited a wide range of mortality risk over a 10- year period. Our models can identify higher risk individuals who can be targeted for interventions to reduce risk of mortality, for participants with or without chronic obstructive pulmonary disease (COPD) using current Global initiative for obstructive Lung Disease (GOLD) criteria.
Sections du résumé
BACKGROUND
BACKGROUND
Risk factor identification is a proven strategy in advancing treatments and preventive therapy for many chronic conditions. Quantifying the impact of those risk factors on health outcomes can consolidate and focus efforts on individuals with specific high-risk profiles. Using multiple risk factors and longitudinal outcomes in 2 independent cohorts, we developed and validated a risk score model to predict mortality in current and former cigarette smokers.
METHODS
METHODS
We obtained extensive data on current and former smokers from the COPD Genetic Epidemiology (COPDGene
RESULTS
RESULTS
Of 9867 COPDGene participants with standard baseline data, 17.6% died over 10 years of follow-up, and 9074 of these participants had the full set of baseline predictors (standard plus 6-minute walk distance and computed tomography variables) available for full model fits. The average age of participants in the cohort was 60 for both men and women, and the average predicted 10-year mortality risk was 18% for women and 25% for men. Model time-integrated area under the receiver operating characteristic curve statistics demonstrated good predictive model accuracy (0.797 average), validated in the external cohort (0.756 average). Risk of mortality was impacted most by 6-minute walk distance, forced expiratory volume in 1 second and age, for both men and women.
CONCLUSIONS
CONCLUSIONS
Current and former smokers exhibited a wide range of mortality risk over a 10- year period. Our models can identify higher risk individuals who can be targeted for interventions to reduce risk of mortality, for participants with or without chronic obstructive pulmonary disease (COPD) using current Global initiative for obstructive Lung Disease (GOLD) criteria.
Identifiants
pubmed: 32877963
doi: 10.15326/jcopdf.7.4.2020.0146
pmc: PMC7883903
doi:
Types de publication
Journal Article
Langues
eng
Pagination
346-361Subventions
Organisme : NIEHS NIH HHS
ID : P30 ES005605
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL133137
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL089856
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL137880
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL149861
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL151452
Pays : United States
Organisme : NHLBI NIH HHS
ID : K23 HL136851
Pays : United States
Informations de copyright
JCOPDF © 2020.
Déclaration de conflit d'intérêts
The COPDGene
Références
Ann Am Thorac Soc. 2015 Jul;12(7):988-96
pubmed: 25844673
Circulation. 2008 Feb 12;117(6):743-53
pubmed: 18212285
Am J Respir Crit Care Med. 2018 Dec 1;198(11):1397-1405
pubmed: 29874098
JAMA. 2016 Feb 16;315(7):672-81
pubmed: 26881370
Ann Am Thorac Soc. 2018 Dec;15(Suppl 4):S243-S248
pubmed: 30759006
Eur Respir J. 2004 Jan;23(1):28-33
pubmed: 14738227
Respir Res. 2014 Aug 06;15:89
pubmed: 25096860
Am J Respir Crit Care Med. 2013 Feb 15;187(4):382-6
pubmed: 23262518
COPD. 2012 Aug;9(5):466-72
pubmed: 22676387
Respir Med. 2014 Mar;108(3):491-9
pubmed: 24280543
Stat Med. 1992 Oct-Nov;11(14-15):1871-9
pubmed: 1480879
Am J Respir Crit Care Med. 2009 Dec 15;180(12):1189-95
pubmed: 19797160
Am J Respir Crit Care Med. 2016 Dec 15;194(12):1483-1493
pubmed: 27332504
Stat Med. 2004 May 30;23(10):1631-60
pubmed: 15122742
Stat Med. 2012 May 20;31(11-12):1150-61
pubmed: 21997569
Radiology. 2018 Sep;288(3):859-866
pubmed: 29762095
AJR Am J Roentgenol. 2013 Sep;201(3):W460-70
pubmed: 23971478
Lancet Respir Med. 2015 Jun;3(6):443-50
pubmed: 25995071
Thorax. 2014 May;69(5):491-4
pubmed: 24029743
Respir Med. 2009 May;103(5):692-9
pubmed: 19131231
Respir Med. 2019 Jan;146:36-41
pubmed: 30665516
N Engl J Med. 2012 Sep 6;367(10):913-21
pubmed: 22938715
Radiology. 2011 Oct;261(1):274-82
pubmed: 21788524
Am J Respir Crit Care Med. 2007 Sep 15;176(6):532-55
pubmed: 17507545
Am J Respir Crit Care Med. 2002 Jul 1;166(1):111-7
pubmed: 12091180
BMC Med. 2018 Mar 2;16(1):33
pubmed: 29495970
Stat Med. 2006 Oct 30;25(20):3474-86
pubmed: 16220486
J Thorac Imaging. 2019 Mar;34(2):92-102
pubmed: 30802233
N Engl J Med. 2004 Mar 4;350(10):1005-12
pubmed: 14999112
Postgrad Med J. 2007 Jul;83(981):492-7
pubmed: 17621621
N Engl J Med. 2016 May 12;374(19):1811-21
pubmed: 27168432
COPD. 2014 Aug;11(4):381-7
pubmed: 24111845
J Am Coll Cardiol. 2014 Jul 1;63(25 Pt B):2935-2959
pubmed: 24239921
Am J Respir Crit Care Med. 1995 Sep;152(3):1107-36
pubmed: 7663792
JAMA Intern Med. 2015 Sep;175(9):1539-49
pubmed: 26098755
Am J Respir Crit Care Med. 2018 Feb 15;197(4):463-469
pubmed: 29099607
BMC Pulm Med. 2012 Oct 01;12:61
pubmed: 23025326
COPD. 2010 Feb;7(1):32-43
pubmed: 20214461
Stat Med. 1997 Feb 28;16(4):385-95
pubmed: 9044528
Lancet. 2009 Aug 29;374(9691):704-11
pubmed: 19716962
Respirology. 2015 May;20(4):541-7
pubmed: 25823703