Publication Date

9-1-2023

Journal

European Respiratory Journal

DOI

10.1183/13993003.00806-2023

PMID

37678951

PMCID

PMC10533946

PubMedCentral® Posted Date

9-28-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Middle Aged, Humans, Bronchitis, Chronic, Pulmonary Disease, Chronic Obstructive, Forced Expiratory Volume, Vital Capacity, Smoking, Spirometry, Lung

Abstract

BACKGROUND: The lifetime risk of developing clinical COPD among smokers ranges from 13% to 22%. Identifying at-risk individuals who will develop overt disease in a reasonable timeframe may allow for early intervention. We hypothesised that readily available clinical and physiological variables could help identify ever-smokers at higher risk of developing chronic airflow limitation (CAL).

METHODS: Among 2273 Lovelace Smokers' Cohort (LSC) participants, we included 677 (mean age 54 years) with normal spirometry at baseline and a minimum of three spirometries, each 1 year apart. Repeated spirometric measurements were used to determine incident CAL. Using logistic regression, demographics, anthropometrics, smoking history, modified Medical Research Council dyspnoea scale, St George's Respiratory Questionnaire, comorbidities and spirometry, we related variables obtained at baseline to incident CAL as defined by the Global Initiative for Chronic Obstructive Lung Disease and lower limit of normal criteria. The predictive model derived from the LSC was validated in subjects from the COPDGene study.

RESULTS: Over 6.3 years, the incidence of CAL was 26 cases per 1000 person-years. The strongest independent predictors were forced expiratory volume in 1 s (FEV

CONCLUSION: In middle-aged ever-smokers, a simple predictive model with FEV

Comments

See commentary "All roads lead to COPD… or not?" with doi: 10.1183/13993003.01470-2023.

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