Airflow obstruction and small airway dysfunction following pulmonary tuberculosis: a cross-sectional survey

Meng

et al. 2023

IJERPH

Coal workers are more likely to develop chronic obstructive pulmonary disease due to exposure to occupational hazards such as dust. In this study, a risk scoring system is constructed according to the optimal model to provide feasible suggestions for the prevention of chronic obstructive pulmonary disease in coal workers. Using 3955 coal workers who participated in occupational health check-ups at Gequan mine and Dongpang mine of Hebei Jizhong Energy from July 2018 to August 2018 as the study subjects, random forest, logistic regression, and convolutional neural network models are established, and model performance is evaluated to select the optimal model, and finally a risk scoring system is constructed according to the optimal model to achieve model visualization. The training set results show that the logistic, random forest, and CNN models have sensitivities of 78.55%, 86.89%, and 77.18%; specificities of 85.23%, 92.32%, and 87.61%; accuracies of 81.21%, 85.40%, and 83.02%; Brier scores of 0.14, 0.10, and 0.14; and AUCs of 0.76, 0.88, and 0.78, respectively, and similar results are obtained for the test set and validation set, with the random forest model outperforming the other two models. The risk scoring system constructed according to the importance ranking of random forest predictor variables has an AUC of 0.842; the evaluation results of the risk scoring system shows that its accuracy rate is 83.7% and the AUC is 0.827, and the established risk scoring system has good discriminatory ability. The random forest model outperforms the CNN and logistic regression models. The chronic obstructive pulmonary disease risk scoring system constructed based on the random forest model has good discriminatory power.

Section: Discussionmentioning

confidence: 99%

Development and Internal Validation of Risk Assessment Models for Chronic Obstructive Pulmonary Disease in Coal Workers

Meng

et al. 2023

IJERPH

“…The most affected variables are FVC and FEV1, which present a more pronounced fall between 3 and 10 years apparently due to the gradual loss of lung elasticity [ 26 ]. In the study by Xing et al, it was reported that lung function parameters were worse in people who had tuberculosis, especially if this deterioration in lung function was not diagnosed or treated, which can result in increased mortality [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis Mortality in Children under Fifteen Years of Age: Epidemiological Situation in Colombia, 2010–2018

2022

Pediatric tuberculosis is a serious infectious disease and a hidden global epidemic. The objective of this study was to describe the epidemiological situation of tuberculosis mortality in children under 15 years of age in Colombia in the period 2010–2018. A longitudinal descriptive study was conducted. The variables sex, age groups, and origin were studied. This study had 260 cases for analysis and was carried out in three phases. The first phase was the determination of the sociodemographic and clinical characteristics. The second phase was the construction of indicators by territorial entities. The third phase was stratification into four epidemiological situations according to the mortality rate and years of life lost. The median age was 7 years (range 0–1 4), 66.5% of cases were pulmonary tuberculosis (97,7% without bacteriological confirmation), 14.3781 years of life lost were recorded (95% CI: 142.811–168.333), and in children under 10–14 years, the loss was 110,057. Amazonas had the highest adjusted YLL rate (3979.7). In total, 36,4% of the territories had a high mortality, and 30,3% adjusted to the situation designated as 1. This is the first study that has used composite indicators to address the problem of premature mortality from childhood tuberculosis in Colombia. Our results allow us to specify that this disease remains a challenge for public health. It requires models of care and differential strategies by region. It also requires ensuring opportunities in diagnosis with sensitive methods, as well as intersectoral work for the optimal approach.

“…We used three indicators of post-bronchodilator spirometry to assess SAD, namely, maximal mid-expiratory flow, forced expiratory flow at 50% of vital capacity, and forced expiratory flow at 75% of vital capacity. When at least two of these three indicators were below 65% of predicted values, we considered the participants to have SAD (1,13). Non-COPD was defined as a post-bronchodilator spirometry FEV 1 /FVC value of ≥0.70, mild COPD as a post-bronchodilator FEV 1 /FVC <0.70, and FEV 1 ≥80% of the predicted value.…”

Section: Study Design and Participantsmentioning

confidence: 99%

“…There are many approaches available for evaluation of small airway function, including spirometry, forced oscillation, nitrogen washout, peripheral wedged catheters, and highresolution computed tomography (12). Spirometry is the most widely used method in clinical practice, and we have used post-bronchodilator spirometry to assess SAD because of the need to obtain data comparable with those reported previously, especially in the Chinese population (1,13).…”

Section: Introductionmentioning

confidence: 99%

Impaired exercise capacity in individuals with non-obstructive small airway dysfunction

Deng¹,

Li²,

Li³

et al. 2023

J Thorac Dis

Background: Whether individuals with non-obstructive spirometry-defined small airway dysfunction (SAD) have impaired exercise capacity is unclear, particularly in never-smokers. This study clarifies the degree of impaired exercise capacity and its potential cause in individuals with non-obstructive SAD. Methods: This community-based, multiyear cross-sectional study analyzed data collected in Guangdong, China from 2012-2019 by the National Science and Technology Support Plan Program. Measurements of exercise capacity [peak work rate and peak oxygen uptake (  V O 2peak )] in participants with non-obstructive spirometry-defined SAD (n=157) were compared with those in controls (n=85) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) I patients (n=239). Subgroup analyses were performed by smoking status.Results: The risk of impaired exercise capacity was significantly higher in participants with non-obstructive, adjusted odds ratio (aOR) =2.53; 95% confidence interval (CI): 1.42-4.52] than in controls but was not significantly different from that in GOLD I patients. Results were consistent within subgroups of smoking status (ever-smokers: non-obstructive SAD vs. controls, aOR =2.44; 95% CI: 1.08-5.51; never-smokers: non-obstructive SAD vs. controls, aOR =2.38, 95% CI: 1.02-5.58). Participants with non-obstructive SAD had a significantly lower peak work rate (β=−10.5; 95% CI: −16.3 to −4.7) and  V O 2peak (%predicted, β=−4.0; 95% CI: −7.7 to −0.2) and tended to have higher ventilatory equivalents for carbon dioxide at the ventilatory threshold (  V E /  V CO 2AT , β=1.1; 95% CI: −0.1 to 2.3) when compared with controls. Both peak work rate andConclusions: Although not meeting the current criteria for chronic obstructive pulmonary disease, individuals with non-obstructive SAD have impaired exercise capacity that may be associated with ventilatory inefficiency regardless of smoking status.