The University of Southampton
University of Southampton Institutional Repository
Warning ePrints Soton is experiencing an issue with some file downloads not being available. We are working hard to fix this. Please bear with us.

Improved outcomes in ex-smokers with COPD: a UK primary care observational cohort study

Improved outcomes in ex-smokers with COPD: a UK primary care observational cohort study
Improved outcomes in ex-smokers with COPD: a UK primary care observational cohort study
Smoking cessation in chronic obstructive pulmonary disease (COPD) reduces accelerated forced expiratory volume in 1 s decline, but impact on key health outcomes is less clear. We studied the relationship of smoking status to mortality and hospitalisation in a UK primary care COPD population.

Using patient-anonymised routine data in the Hampshire Health Record Analytical Database, we identified a prevalent COPD cohort, categorising patients by smoking status (current, ex- or never-smokers). Three outcomes were measured over 3 years (2011–2013): all-cause mortality, respiratory-cause unplanned hospital admission and respiratory-cause emergency department attendance. Survival analysis using multivariable Cox regression after multiple imputation was used to estimate hazard ratios for each outcome by smoking status, adjusting for measured confounders (including age, lung function, socioeconomic deprivation, inhaled medication and comorbidities).

We identified 16 479 patients with COPD, mean±sd age 70.1±11.1 years. Smoking status was known in 91.3%: 35.1% active smokers, 54.3% ex-smokers, 1.9% never-smokers. Active smokers predominated among younger patients. Compared with active smokers (n=5787), ex-smokers (n=8941) had significantly reduced risk of death, hazard ratio (95% confidence interval) 0.78 (0.70–0.87), hospitalisation, 0.82 (0.74–0.89) and emergency department attendance, 0.78 (0.70–0.88).

After adjusting for confounders, ex-smokers had significantly better outcomes, emphasising the importance of effective smoking cessation support, regardless of age or lung function.
COPD , smoking, Electronic health record data, PRIMARY CARE, MORTALITY, hospitalisation
1-9
Josephs, Lynn
865f1878-f0ca-42c3-a030-df6dcbc705b0
Culliford, David
25511573-74d3-422a-b0ee-dfe60f80df87
Johnson, Matthew James
d272ca76-f017-4457-96f5-daf6a7af6adf
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953
Josephs, Lynn
865f1878-f0ca-42c3-a030-df6dcbc705b0
Culliford, David
25511573-74d3-422a-b0ee-dfe60f80df87
Johnson, Matthew James
d272ca76-f017-4457-96f5-daf6a7af6adf
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953

Josephs, Lynn, Culliford, David, Johnson, Matthew James and Thomas, Mike (2017) Improved outcomes in ex-smokers with COPD: a UK primary care observational cohort study. The European respiratory journal, 49 (5), 1-9, [1602114]. (doi:10.1183/13993003.02114-2016).

Record type: Article

Abstract

Smoking cessation in chronic obstructive pulmonary disease (COPD) reduces accelerated forced expiratory volume in 1 s decline, but impact on key health outcomes is less clear. We studied the relationship of smoking status to mortality and hospitalisation in a UK primary care COPD population.

Using patient-anonymised routine data in the Hampshire Health Record Analytical Database, we identified a prevalent COPD cohort, categorising patients by smoking status (current, ex- or never-smokers). Three outcomes were measured over 3 years (2011–2013): all-cause mortality, respiratory-cause unplanned hospital admission and respiratory-cause emergency department attendance. Survival analysis using multivariable Cox regression after multiple imputation was used to estimate hazard ratios for each outcome by smoking status, adjusting for measured confounders (including age, lung function, socioeconomic deprivation, inhaled medication and comorbidities).

We identified 16 479 patients with COPD, mean±sd age 70.1±11.1 years. Smoking status was known in 91.3%: 35.1% active smokers, 54.3% ex-smokers, 1.9% never-smokers. Active smokers predominated among younger patients. Compared with active smokers (n=5787), ex-smokers (n=8941) had significantly reduced risk of death, hazard ratio (95% confidence interval) 0.78 (0.70–0.87), hospitalisation, 0.82 (0.74–0.89) and emergency department attendance, 0.78 (0.70–0.88).

After adjusting for confounders, ex-smokers had significantly better outcomes, emphasising the importance of effective smoking cessation support, regardless of age or lung function.

Text
1602114.full - Version of Record
Available under License Creative Commons Attribution.
Download (417kB)

More information

Accepted/In Press date: 15 February 2017
e-pub ahead of print date: 23 May 2017
Published date: May 2017
Additional Information: This article has been identified by ERJ for continuing medical education (CME)
Keywords: COPD , smoking, Electronic health record data, PRIMARY CARE, MORTALITY, hospitalisation
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 409581
URI: http://eprints.soton.ac.uk/id/eprint/409581
PURE UUID: 6160ed5e-abc0-4065-9df4-67e8a5ec964e
ORCID for David Culliford: ORCID iD orcid.org/0000-0003-1663-0253

Catalogue record

Date deposited: 31 May 2017 04:01
Last modified: 22 Nov 2021 02:51

Export record

Altmetrics

Contributors

Author: Lynn Josephs
Author: David Culliford ORCID iD
Author: Matthew James Johnson
Author: Mike Thomas

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×