Association of Nonobstructive Chronic Bronchitis With All-Cause Mortality

Fortis, Spyridon; Shannon, Zacariah K.; Garcia, Crystal; Guillamet, Rodrigo Vazquez; Aloe, Ariel M.; Schweizer, Marin L.; Kim, Victor; Nair, Rajeshwari

doi:10.1016/j.chest.2022.02.003

Cited by 8 publications

(8 citation statements)

References 32 publications

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“…The Tucson study recruited 1,412 subjects with normal spirometry between 1972–1973 and, after following for 30 years, also demonstrated a 31% increased risk of death with chronic bronchitis ( 32 ). Similar hazard ratios of death with chronic productive cough ranging between 1.23 to 1.56 have been reported in older cohort studies from Norway, UK, Poland, Oregon, and Paris ( 19 , 33 - 37 ). Whilst the estimated 49% increased risk of death with chronic productive cough in this study is consistent with previous data, it is also slightly disappointing.…”

Section: Discussionsupporting

confidence: 83%

“…As the exact date of death and withdrawal are missing, Logistic Regression (LR) models were used to estimate the odds ratios (OR) and 95% confidence intervals (95% CI) for the outcome of mortality. Potential confounding covariates associated with chronic cough and mortality were identified from prior literature describing associations, clinical relevance and mechanistic plausibility ( 19 , 29 ). The univariate association between each variable and mortality was assessed; a set of pre-defined variables were considered candidates for the model.…”

Section: Methodsmentioning

confidence: 99%

“…A number of cohort studies showed chronic bronchitis was associated with increased mortality in men, smokers, chronic obstructive pulmonary disease (COPD) and in those with lower lung function (19)(20)(21)(22)(23)(24)(25)(26). However, these earlier studies had limitations as the focus was on the inclusion of participants with COPD, smokers, and use of occupational cohorts.…”

Section: Introductionmentioning

confidence: 99%

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Impact of productive and dry chronic cough on mortality in the Canadian Longitudinal Study on Aging (CLSA)

Satia¹,

Mayhew²,

Sohel³

et al. 2022

J Thorac Dis

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Background: Chronic cough is a common troublesome condition and accounts for a high burden on quality of life. Previous data investigating the mortality associated with chronic cough has been derived in patients with chronic bronchitis. No data exists on chronic dry cough. Therefore, we investigated if chronic dry and productive cough is independently associated with increased mortality. Methods:The Canadian Longitudinal Study on Ageing (CLSA) is a prospective, nationally generalizable, stratified random sample of adults aged 45-85 years at baseline recruited between 2011-2015 and followed up three years later. Chronic cough was identified based on a self-reported daily cough in the last 12 months.Deaths were confirmed by the Ministry of Health and/or completion of descendent questionnaire by a family member. Models were investigated for dry and productive chronic cough and was adjusted for age, sex, smoking, body mass index (BMI), and respiratory diseases.Results: Of the 30,016 participants, 4,783 (15.9%) reported chronic cough at baseline; 2,724 (57%) had a dry cough, and 2,059 (43%) had productive chronic cough. There was a total of 561 deaths between baseline and follow-up-1 (3 years later). There was a 49% higher risk of death in participants with chronic productive cough {adjusted odds ratio (aOR) 1.49 [95% confidence intervals (CI): 1.08-2.07]}, but not dry chronic cough ]. The effects of chronic productive cough on mortality were persistent in those with no airflow obstruction [chronic productive cough aOR 1.90 (1.09-3.31)].Conclusions: Chronic productive cough is associated with a higher risk of death, while chronic dry cough has no impact on mortality risk of death in middle-aged and older adults. This highlights the importance of careful evaluation of patients with chronic cough.

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Section: Discussionsupporting

confidence: 83%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of productive and dry chronic cough on mortality in the Canadian Longitudinal Study on Aging (CLSA)

Satia¹,

Mayhew²,

Sohel³

et al. 2022

J Thorac Dis

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“…An important finding in our population is that smokers without COPD but with CB have a significant increase in all-cause mortality when compared with noCOPD smokers without CB, a fact that has been well known for smokers with COPD and CB, as we could demonstrate in our population. However, it is only more recently that it has been shown that even noCOPD smokers with CB have a lower survival rate [ 40 ]. Interestingly enough, this is not the case with the chronic bronchitis seen in non-smokers [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Chronic Bronchitis Affects Outcomes in Smokers without Chronic Obstructive Pulmonary Disease (COPD)

Casara

Turato

Semenzato

et al. 2022

JCM

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Background. Chronic bronchitis (CB) importantly affects outcomes in smokers with COPD, but the effects on smokers without COPD are less well known and less emphasized. The aim of our study was to investigate the possible effects of CB on clinical outcomes in smokers without COPD (noCOPD) and compare them with the effects in smokers with COPD (COPD). Methods. For that purpose, we studied 511 smokers, 302 with and 209 without COPD, followed for 10 years in an academic COPD ambulatory setting. Chronic bronchitis was defined as the presence of cough and sputum production for at least 3 months in each of two consecutive years. All subjects underwent clinical and functional examination with spirometry, diffusion capacity (DLco), 6-min walking test (6MWT), mMRC Dyspnoea Scale, COPD Assessment Test (CAT), and recording of annual frequency of exacerbations. All-cause mortality during follow-up was recorded. Results. 27% of noCOPD and 45% of COPD had CB. noCOPD with CB had lower FEV1 and DLco, worse 6MWT, more dyspnoea, a higher number of exacerbations and lower survival than noCOPD without CB. CB did not affect FEV1 decline in noCOPD but it significantly did in COPD. Conclusions. The presence of chronic bronchitis in smokers without COPD will significantly affect symptoms, quality of life, and survival, underlining the importance of recognizing the condition and managing it accordingly.

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“…In this issue of CHEST, Fortis et al 2 report results from a timely systematic review and meta-analysis, in which, when findings from eight studies were combined, nonobstructive CB was found to be associated with an increased risk for all-cause death. The meta-analysis included studies that used the traditional definition of CB based on chronic cough and phlegm as well as studies that used broader definitions that comprised multiple respiratory symptoms.…”

mentioning

confidence: 99%

Nonobstructive Chronic Bronchitis

Guerra

2022

Chest

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Association of Nonobstructive Chronic Bronchitis With All-Cause Mortality

Cited by 8 publications

References 32 publications

Impact of productive and dry chronic cough on mortality in the Canadian Longitudinal Study on Aging (CLSA)

Impact of productive and dry chronic cough on mortality in the Canadian Longitudinal Study on Aging (CLSA)

Chronic Bronchitis Affects Outcomes in Smokers without Chronic Obstructive Pulmonary Disease (COPD)

Nonobstructive Chronic Bronchitis

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