COPD AND LUNG FUNCTION PARAMETERS AS PREDICTORS OF MORTALITY: THE PLATINO COHORT STUDY

Menezes, Ana Maria

COPD AND LUNG FUNCTION PARAMETERS AS PREDICTORS OF MORTALITY: THE PLATINO COHORT STUDY

Monday, 18 August 2014

Exhibit hall (Dena'ina Center)

Ana Maria B Menezes, PhD , Universidade Federal de Pelotas, Pelotas, Brazil

Rogelio Perez Padilla, MD , National Institute of Respiratory Diseases, Mexico City, Mexico

Fernando C Wehrmeister, PhD , Federal University of Pelotas, Pelotas, Brazil

Maria Victorina Lopez-Varela, MD , Universidad de la Republica, Montevideo, Uruguay

Adriana Muiño, MD , Centro Hospitalario Pereira Rossel, Montevideo, Uruguay

Gonzalo Valdivia, MD , Pontificia Universidad Catolica de Chile, Santiago, Chile

Carmen Lisboa, MD , Pontificia Universidad Católica de Chile, Santiago, Chile

José Roberto B Jardim, MD , Federal University of São Paulo, São Paulo, Brazil

Maria Montes de Oca, MD , Universidad Central de Venezuela, Caracas, Venezuela

Carlos Tálamo, MD , Universidad Central de Venezuela, Caracas, Venezuela

Renata M Bielemann, PhD , Universidade Federal de Pelotas, Pelotas, Brazil

Mariana Gazzotti, PhD , Federal University of São Paulo, São Paulo, Brazil

Ruy Laurenti, MD , University of Sao Paulo, São Paulo, Brazil

Bartolomé Celli, MD , St. Elizabeth's Medical Center, Boston, MA

Cesar G Victora, PhD , Universidade Federal de Pelotas, Pelotas, Brazil

For the PLATINO Team , For the PLATINO Team, Pelotas, Brazil

INTRODUCTION:

It is know that low lung function and COPD can predict subsequent mortality in high income countries. The aim of this study was to describe mortality rates according to COPD and lung function in cohorts from three Latin American (LA) cities.

METHODS: A population based adult cohort was followed up in Montevideo, Santiago and Sao Paulo during 5, 6 and 9 years, respectively. The outcomes evaluated were: all-cause, cardiovascular, respiratory and cancer mortality; exposures were COPD and lung function parameters (FEV₁and FVC). Cox regression was used in confounder-adjusted analyses. We also calculated sensitivity, specificity, positive and negative predictive values, ROC curves and Youden’s index.

RESULTS: The main causes of death were cardiovascular, respiratory and cancer. In the adjusted models including both genders, baseline COPD was associated with overall mortality (HR 1.43 for FEV1/FVC<LLN, 2.01 for GOLD 2-4, 1.46 for the fixed ratio (FEV1/FVC<0.7) and 1.50 for FEV₁/FEV₆ < LLN). For cardiovascular mortality, significant associations were found with GOLD 2-4 (HR 2.68) and with the fixed ratio (HR 1.78) for both sexes together but not among women. Low FEV₁ was associated with an increased risk for overall and respiratory mortality in both sexes combined. FVC did not show a significant association with overall mortality. For most COPD criteria sensitivity was low and specificity high. The area under the curve for FEV₁was greater than for FVC for overall and cardiovascular mortality.

CONCLUSIONS: COPD and low FEV₁are important predictors for overall and cardiovascular mortality in LA.