Abstract
Risk factors for death from respiratory failure in the general population are not established. The aim of this study was to determine the characteristics of individuals who die of respiratory failure in a Japanese general population. In total, 3253 adults aged 40 years or older participated in annual health check in Takahata, Yamagata, Japan from 2004 to 2006. Subject deaths through the end of 2010 were reviewed; 27 subjects died of respiratory failure (pneumonia, n = 22; COPD, n = 1; pulmonary fibrosis, n = 3; and bronchial asthma, n = 1). Cox proportional hazard analysis revealed that male sex; higher age, high levels of D-dimer and fibrinogen; lower body mass index (BMI) and total cholesterol; and history of stroke and gastric ulcer were independent risk factors for respiratory death. On analysis with C-statistics, net reclassification improvement, and integrated discrimination improvement, addition of the disease history and laboratory data significantly improved the model prediction for respiratory death using age and BMI. In conclusion, we identified risk factors for mortality from respiratory failure in a prospective cohort of a Japanese general population. Men who were older, underweight, hypocholesterolemic, hypercoagulo-fibrinolytic, and had a history of stroke or gastric ulcer had a higher risk of mortality due to respiratory failure.
Highlights
Risk factors for death from respiratory failure in the general population are not established
The subject population was divided into three groups as follows: subjects who were alive at the end of the study period; those died of respiratory failure; and those who died of diseases other than respiratory failure
Male sex, and low body mass index (BMI) were strong risk factors for death by respiratory failure, we evaluated whether including the disease history and laboratory data (TC, D-D, and fibrinogen) with the basic parameters improved the prediction of respiratory death in the Cox proportional hazard analysis by using C-statistics
Summary
Risk factors for death from respiratory failure in the general population are not established. Low FEV1 was a significant risk factor for death by respiratory failure in a univariate Cox proportional hazard analysis, low FEV1 was not a risk for respiratory death independent of other confounding factors such as age, sex, smoking, blood pressure, liver function, renal function, and dyslipidemia in multivariate analysis[2]. This result suggests that the risk of respiratory death cannot be evaluated solely based on pulmonary function. The aim of this study was to determine the characteristics of individuals who die by respiratory failure in a Japanese general population
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