کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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4211441 | 1280640 | 2008 | 6 صفحه PDF | دانلود رایگان |

SummaryObjectivesTo evaluate the association between pulmonary restriction and mortality in the elderly, taking into account potential confounders not considered in the past (disability, cognitive dysfunction, diabetes, and visceral obesity).DesignLongitudinal study.SettingCommunity-based.ParticipantsTwelve hundred sixty-five patients (51.9% men) aged 65–97 years old from the Salute Respiratoria nell'Anziano (SaRA) Italian multicentric study.MeasurementsParticipants were divided in 4 groups: normal spirometry (NS): FEV1/FVC ≥ 70%, FVC ≥ 80% of predicted; restrictive ventilatory pattern (RVP): FEV1/FVC ≥ 70%, FVC < 80%; obstructive ventilatory pattern (OVP): FEV1/FVC < 70%, FVC ≥ 80%, and mixed ventilatory pattern (MVP): FEV1/FVC < 70%, FVC < 80%. We calculated the association between restriction and mortality corrected for potential confounders using a multivariable Cox regression model.ResultsWe found a prevalence of RVP, OVP and MVP of 10.9%, 25.4%, and 17.3%, respectively. Compared to people with normal spirometric pattern, disability (19.6% vs. 10.1%), poor physical performance (35.4% vs. 22.3%), cognitive impairment (21.0% vs. 11.5%), increased waist circumference (62.1% and 26.8%), and kyphoscoliosis (56.8 and 13.5%) were more prevalent in the RVP group. After correction for potential confounders, RVP was associated with increased mortality (HR: 1.89; 95% CI: 1.15–3.11), as well as OVP (HR: 2.33; 95% CI: 1.58–3.11) and MVP (HR: 2.60; 95% CI: 1.74–3.93). Other factors associated with mortality were disability (HR: 1.92; 95% CI: 1.35–2.72), poor physical performance (HR: 1.37; 95% CI: 1.01–1.85), cognitive impairment (HR: 1.55; 95% CI: 1.06–2.27), depression (HR: 1.57; 95% CI: 1.16–2.13) and diagnosis of stroke (HR: 1.90; 95% CI: 1.18–3.05).ConclusionsRVP is associated with higher mortality in the elderly and, thus, deserves the same attention paid to an obstructive pattern. However, mechanisms mediating this association need to be clarified.
Journal: Respiratory Medicine - Volume 102, Issue 9, September 2008, Pages 1349–1354