Parametric estimation of age-, sex-, and spirometry grade-specific mortality in a cohort of COPD patients from Germany: Results from COSYCONET

Niedermaier, Tobias ; Alter, Peter ; Jörres, Rudolf A. ; Vogelmeier, Claus F. und Holle, Rolf (2025): Parametric estimation of age-, sex-, and spirometry grade-specific mortality in a cohort of COPD patients from Germany: Results from COSYCONET. In: Respiratory Medicine, Bd. 247, 108280

Abstract

Background

Chronic obstructive pulmonary disease (COPD) substantially contributes to morbidity and mortality worldwide. We aimed at estimating Global Initiative for Chronic Obstructive Lung Disease (GOLD) spirometric grade-specific mortality in COPD for Germany, using data from a large-scale cohort of patients with COPD.

Methods

Using COSYCONET data, a cohort of 2741 patients diagnosed with COPD was followed over up to 9 years. We estimated mortality rates for GOLD grades 1 to 4 and stratified into age and sex groups. An exponential survival model was used to estimate mortality after checking model assumptions. Additionally, a Cox proportional hazards model was estimated as plausibility check for the exponential model.

Results

A total of 345 deaths were observed during the follow-up period. The data fitted well to an exponential survival model when the first year of follow-up was excluded, suggesting a “healthy participant effect”. GOLD grade was a strong predictor of mortality, with hazard ratios of 1.6, 3.2, and 8.8 for GOLD 2–4 compared to GOLD 1. Hazard ratios of the Cox model were similar (1.7, 3.4, and 10.0 for grades 2–4 compared to grade 1). At a given grade, mortality strongly increased with age. 1-year mortality ranged from 0.5 % (GOLD 1, <55 years, females) to 54.9 % (GOLD 4, 80+ years, males). Mortality was lower among females by approximately 25 %.

Conclusion

Based on our findings, mortality in COPD depends on GOLD grade, age, sex and smoking status. Parametric estimation allowed to estimate 1-year mortality for each combination of COPD grade and age group, including uncertainty estimates.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin > Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 09546111
• Sprache: Englisch