Association Between Preserved Ratio Impaired Spirometry and Clinical Outcomes in US Adults
An erratum to this article was published (JAMA, 18 Jan 2022 ↗)
Authors' conclusion
In a large, population-based sample of US adults, baseline PRISm, compared with normal spirometry, was associated with a small but statistically significant increased risk for mortality and adverse cardiovascular and respiratory outcomes.
Study context
- Population
- US adults aged 18 to 102 years, National Heart, Lung, and Blood Institute (NHLBI) Pooled Cohorts Study, 1971–201153,701 with valid baseline lung function
- Participants
- 65,251 adults
- Exposure
- Preserved ratio impaired spirometry (PRISm) vs normal spirometry
- PRISmn = 4,582
- Outcome
- All-cause mortality, respiratory-related mortality, CHD-related mortality, respiratory-related events and CHD-related events (hospitalizations and mortality)
Methodological detailspooled data from 9 US general population-based cohorts, Final follow-up December 2018, Models adjusted for age, sex, race and ethnicity, education, BMI, smoking status, cohort and comorbidities
- Pooled data from 9 US general population-based cohorts
- Final follow-up December 2018
- Models adjusted for age, sex, race and ethnicity, education, BMI, smoking status, cohort and comorbidities
Main finding
As reported in the abstract
PRISm
- All-cause mortality
- 29.6/1000 person-years
- Respiratory-related mortality
- 2.1/1000 person-years
- Coronary heart disease (CHD)-related mortality
- 5.4/1000 person-years
- Respiratory-related events
- 12.2/1000 person-years
- CHD-related events
- 11.7/1000 person-years
Normal spirometry
- All-cause mortality
- 18.0/1000 person-years
- Respiratory-related mortality
- 1.0/1000 person-years
- CHD-related mortality
- 2.6/1000 person-years
- Respiratory-related events
- 6.0/1000 person-years
- CHD-related events
- 7.0/1000 person-years
All-cause mortality
PRISm29.6/1000 person-years
Normal spirometry18.0/1000 person-years
Respiratory-related mortality
PRISm2.1/1000 person-years
Normal spirometry1.0/1000 person-years
Coronary heart disease (CHD)-related mortality
PRISm5.4/1000 person-years
Normal spirometry2.6/1000 person-years
Respiratory-related events
PRISm12.2/1000 person-years
Normal spirometry6.0/1000 person-years
CHD-related events
PRISm11.7/1000 person-years
Normal spirometry7.0/1000 person-years
PRISm vs Normal spirometryDifference, /1000 person-years (95% CI)
All-cause mortality
11.6(10.0–13.1)
Respiratory-related mortality
1.1(0.7–1.6)
CHD-related mortality
2.7(2.1–3.4)
Respiratory-related events
6.2(4.9–7.5)
CHD-related events
4.7(3.7–5.8)
PRISm vs Normal spirometryAdjusted hazard ratio (95% CI)
All-cause mortality
1.50(1.42–1.59)
Respiratory-related mortality
1.95(1.54–2.48)
CHD-related mortality
1.55(1.36–1.77)
Respiratory-related events
1.90(1.69–2.14)
CHD-related events
1.30(1.18–1.42)
Observational data: associations, not effects.
Further findings
| Outcome | PRISm | Normal spirometry | PR (95% CI) | |
|---|---|---|---|---|
| Correlates of PRISm (prevalence)Obesity | 1.68 (1.55–1.82) | |||
| Obesity | 48.3% | 31.4% | ||
| Underweight | 1.4% | 1.0% | ||
| Female sex | 60.3% | 59.0% | ||
| Current smoking | 25.2% | 17.5% | ||
| Correlates of PRISm (prevalence)Underweight | 2.20 (1.72–2.82) | |||
| Correlates of PRISm (prevalence)Female sex | 1.07 (1.01–1.13) | |||
| Correlates of PRISm (prevalence)Current smoking | 1.33 (1.22–1.45) | |||
| 0.20.5125Prevalence ratio (log scale) |
- Prevalence of PRISm
- 8.5% · 4582
Original publication
Association Between Preserved Ratio Impaired Spirometry and Clinical Outcomes in US Adults. JAMA. Published 14 December 2021. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →