Early smoking lead to worse prognosis of COPD patients: a real world study
Abstract Background Smoking remains a major risk factor for the development and progression of chronic obstructive pulmonary disease (COPD). Due to the adolescent smoking associated with worse health state, the age, at which an individual started smoking, might play a key role in shaping the traject...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | Respiratory Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12931-024-02760-y |
| _version_ | 1797233378915778560 |
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| author | Jiankang Wu Weiwei Meng Yiming Ma Zhiqi Zhao Ruoyan Xiong Jiayu Wang Rui Zhao Huihui Zeng Yan Chen |
| author_facet | Jiankang Wu Weiwei Meng Yiming Ma Zhiqi Zhao Ruoyan Xiong Jiayu Wang Rui Zhao Huihui Zeng Yan Chen |
| author_sort | Jiankang Wu |
| collection | DOAJ |
| description | Abstract Background Smoking remains a major risk factor for the development and progression of chronic obstructive pulmonary disease (COPD). Due to the adolescent smoking associated with worse health state, the age, at which an individual started smoking, might play a key role in shaping the trajectory of COPD development and the severity. Methods We conducted an observational study from September 2016 through January 2023 of eligible patients hospitalized with COPD. Patients who started smoking during the alveolar development stage (ADS, smoking initiation ≤ 24 years old) were defined as early smoking patients, and patients who started smoking after ADS (smoking initiation > 24 years old) were defined as late smoking patients. We collected demographic and clinical data characterizing the patients and documented their condition from hospital discharge to follow-up. The primary endpoints were short-term (within one year), 3-year, and long-term (beyond 3 years) all-cause mortality after discharge. Results Among 697 COPD patients, early smoking patients had a lower smoking cessation rate (P < 0.001) and a higher smoking index (P < 0.001) than late smoking patients. Although adjusted smoking index, early smoking patients still had poorer lung function (P = 0.023), thicker left ventricular diameters (P = 0.003), higher frequency of triple therapy use during stable stage (P = 0.049), and more acute exacerbations in the past year before enrollment (P < 0.05). Survival analysis showed that they had a higher risk of death after discharge within three years (P = 0.004) and beyond three years (P < 0.001). Furthermore, even in early smoking COPD patients who quit smoking after adjusting the smoking index had poorer lung function (P < 0.05) and thicker left ventricular diameters (P = 0.003), and survival analysis also showed that they had a higher long-term mortality rate (P = 0.010) and shorter survival time (P = 0.0128). Conclusion Early smoking COPD patients exhibited multiple adverse clinical outcomes, including heavy cigarette addiction, compromised pulmonary function, augmented left ventricular diameter, and elevated mortality risk. Additional, smoking cessation could not bring enough improvement of health state in early smoking COPD patients as late smoking COPD patients. Consequently, early intervention and specialized cessation approaches for younger smokers are of paramount importance in this context. |
| first_indexed | 2024-04-24T16:15:14Z |
| format | Article |
| id | doaj.art-2ed2b572c323460fa7b66b0f58c946a6 |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-04-24T16:15:14Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-2ed2b572c323460fa7b66b0f58c946a62024-03-31T11:29:34ZengBMCRespiratory Research1465-993X2024-03-0125111010.1186/s12931-024-02760-yEarly smoking lead to worse prognosis of COPD patients: a real world studyJiankang Wu0Weiwei Meng1Yiming Ma2Zhiqi Zhao3Ruoyan Xiong4Jiayu Wang5Rui Zhao6Huihui Zeng7Yan Chen8Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South UniversityDepartment of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South UniversityDepartment of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South UniversityDepartment of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South UniversityDepartment of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South UniversityDepartment of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South UniversityDepartment of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South UniversityDepartment of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South UniversityDepartment of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South UniversityAbstract Background Smoking remains a major risk factor for the development and progression of chronic obstructive pulmonary disease (COPD). Due to the adolescent smoking associated with worse health state, the age, at which an individual started smoking, might play a key role in shaping the trajectory of COPD development and the severity. Methods We conducted an observational study from September 2016 through January 2023 of eligible patients hospitalized with COPD. Patients who started smoking during the alveolar development stage (ADS, smoking initiation ≤ 24 years old) were defined as early smoking patients, and patients who started smoking after ADS (smoking initiation > 24 years old) were defined as late smoking patients. We collected demographic and clinical data characterizing the patients and documented their condition from hospital discharge to follow-up. The primary endpoints were short-term (within one year), 3-year, and long-term (beyond 3 years) all-cause mortality after discharge. Results Among 697 COPD patients, early smoking patients had a lower smoking cessation rate (P < 0.001) and a higher smoking index (P < 0.001) than late smoking patients. Although adjusted smoking index, early smoking patients still had poorer lung function (P = 0.023), thicker left ventricular diameters (P = 0.003), higher frequency of triple therapy use during stable stage (P = 0.049), and more acute exacerbations in the past year before enrollment (P < 0.05). Survival analysis showed that they had a higher risk of death after discharge within three years (P = 0.004) and beyond three years (P < 0.001). Furthermore, even in early smoking COPD patients who quit smoking after adjusting the smoking index had poorer lung function (P < 0.05) and thicker left ventricular diameters (P = 0.003), and survival analysis also showed that they had a higher long-term mortality rate (P = 0.010) and shorter survival time (P = 0.0128). Conclusion Early smoking COPD patients exhibited multiple adverse clinical outcomes, including heavy cigarette addiction, compromised pulmonary function, augmented left ventricular diameter, and elevated mortality risk. Additional, smoking cessation could not bring enough improvement of health state in early smoking COPD patients as late smoking COPD patients. Consequently, early intervention and specialized cessation approaches for younger smokers are of paramount importance in this context.https://doi.org/10.1186/s12931-024-02760-yEarly smokingCOPDClinical outcomesPrognosis |
| spellingShingle | Jiankang Wu Weiwei Meng Yiming Ma Zhiqi Zhao Ruoyan Xiong Jiayu Wang Rui Zhao Huihui Zeng Yan Chen Early smoking lead to worse prognosis of COPD patients: a real world study Respiratory Research Early smoking COPD Clinical outcomes Prognosis |
| title | Early smoking lead to worse prognosis of COPD patients: a real world study |
| title_full | Early smoking lead to worse prognosis of COPD patients: a real world study |
| title_fullStr | Early smoking lead to worse prognosis of COPD patients: a real world study |
| title_full_unstemmed | Early smoking lead to worse prognosis of COPD patients: a real world study |
| title_short | Early smoking lead to worse prognosis of COPD patients: a real world study |
| title_sort | early smoking lead to worse prognosis of copd patients a real world study |
| topic | Early smoking COPD Clinical outcomes Prognosis |
| url | https://doi.org/10.1186/s12931-024-02760-y |
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