PRISm defined by GLI-2022 equations was associated with a higher all-cause mortality risk (HR 2.2; 95% CI 1.8-2.8) than PRISm defined by Korean-specific equations (HR 1.7; 95% CI 1.5-1.9).
Cohort (n=32,705)
Does defining PRISm using GLI-2022 equations compared to Korean-specific equations better identify patients at higher risk of all-cause mortality?
Using the GLI-2022 equations to define PRISm identifies a smaller cohort with a higher relative risk of all-cause mortality compared to Korean-specific equations.
Effect estimate: HR 2.2 (95% CI 1.8-2.8)
Abstract Rationale Reference equations for pulmonary function tests (PFT) are important for diagnosing and classifying pulmonary diseases. We previously reported a lower prevalence of preserved ratio impaired spirometry (PRISm) by GLI-2022 race-neutral equations than by Korean-specific equations. To elucidate whether this represents better classification or underdiagnosis, we compared the all-cause mortality risks of PRISm by different PFT equations. Methods Participants for the Korean National Health and Nutritional Examination Survey (KNHANES) from 2007 to 2018, who were aged 35-90 years without a prior diagnosis of pulmonary tuberculosis, lung cancer, or bronchiectasis, were included in the analysis. The normal population, PRISm, and chronic obstructive pulmonary disease (COPD) were identified based on forced expiratory volume in one second (FEV1) / forced vital capacity (FVC) by the GLI-2022 and the Korean equations, respectively. We compared all-cause mortality risks of PRISm classified by two different equations using the Cox hazards models and the Kaplan-Meier estimators. Results Among 32,705 participants who met the inclusion criteria, 730 (2.2%) adults were classified as PRISm by the GLI-2022 equations, while 3274 (10.0%) were classified by the Korean equations. PRISm population was associated with a greater risk of mortality compared to the normal population, regardless of spirometry equations (Korean equation: hazard ratio HR 1.7, 95% CI: 1.5-1.9; GLI-2022 equation: HR 2.2, 95% CI: 1.8-2.8). Yet, the differences in mortality risks between PRISm and the normal population were more pronounced with the GLI-2022 equations. Conclusions PRISm by GLI-2022 demonstrated a higher mortality risk than PRISm by the Korean equation in KNHANES 2007-2018. The transition to the GLI-2022 equations may improve the identification of PRISm cases associated with a higher mortality risk. This abstract is funded by: None
Cho et al. (Fri,) conducted a cohort in Preserved ratio impaired spirometry (PRISm) (n=32,705). GLI-2022 equations vs. Korean-specific equations was evaluated on All-cause mortality (HR 2.2, 95% CI 1.8-2.8). PRISm defined by GLI-2022 equations was associated with a higher all-cause mortality risk (HR 2.2; 95% CI 1.8-2.8) than PRISm defined by Korean-specific equations (HR 1.7; 95% CI 1.5-1.9).