Background: Mortality is higher among those with than without COPD but there are few sex-stratified studies on causes of death.
Aim: To study cause-specific death in men and women with chronic airflow obstruction (CAO) and non-obstructive controls.
Methods: Adults with CAO (post-bd FEV1/VC<0.7) and non-obstructive controls (FEV1/VC>0.7), divided into Normal Lung Function (NLF), FEV1/VC?0.7&VC?80% predicted and Restrictive Spirometric Pattern (RSP), FEV1/VC?0.70&VC<80% predicted, were identified from population-based cohorts examined in 2002-04. Causes of death were collected from the Swedish Cause of Death register until December 2015. Hazard for specific causes of death were analyzed by Fine and Gray regression models taking competing risks into account, comparing CAO and RSP to NLF.
Results: There were n=736 CAO, n=251 RSP, and n=742 NLF; 55, 55 and 54% men, respectively. Hazard for respiratory death was higher in CAO and RSP than in NLF (HR;95%CI; 2.7;1.3-5.8 and 2.7;1.1-6.8), independent of age, sex, BMI, smoking habits and pack-years. Similar analyzes stratified for sex revealed 2.2;0.8-6.1 and 2.4;0.7-7.8 among men and 3.4;1.1-11.1 and 1.9;0.4-8.8 among women. Hazard for cardiovascular (CV) death was 1.4;1.0-1.91 and 1.1;0.7-1.6 in CAO and RSP when compared with NLF (in men 1.5;1.0-2.21 and 1.0;0.6-1.7, in women 1.2;0.8-2.0 and 1.4;0.7-2.6). Corresponding analyses of cancer, dementia and other causes of death yielded no significant results.
Conclusion: CAO and RSP had higher hazard for respiratory death than NLF, while CAO also had higher hazard for CV death. In CAO, the higher hazard for respiratory death was driven by women, while the higher hazard for CV death was driven by men.
1p<0.05