Please use this identifier to cite or link to this item: doi:10.22028/D291-37468
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Title: Impact of Education on COPD Severity and All-Cause Mortality in Lifetime Never-Smokers and Longtime Ex-Smokers : Results of the COSYCONET Cohort
Author(s): Lutter, Johanna I.
Jörres, Rudolf A.
Welte, Tobias
Watz, Henrik
Waschki, Benjamin
Alter, Peter
Trudzinski, Franziska C.
Ohlander, Johan
Behr, Jürgen
Bals, Robert
Studnicka, Michael
Holle, Rolf
Vogelmeier, Claus F.
Kahnert, Kathrin
Language: English
Title: International Journal of Chronic Obstructive Pulmonary Disease
Volume: 2020
Issue: 15
Pages: 2787-2798
Publisher/Platform: DOVE
Year of Publication: 2020
Free key words: COPD
socioeconomic status
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: Background: Beyond smoking, several risk factors for the development of chronic obstructive pulmonary disease (COPD) have been described, among which socioeconomic status including education is of particular interest. We studied the contribution of education to lung function and symptoms relative to smoking in a group of never-smokers with COPD compared to a group of long-time ex-smokers with COPD. Methods: We used baseline data of the COSYCONET cohort, including patients of GOLD grades 1–4 who were either never-smokers (n=150, age 68.5y, 53.3% female) or ex-smokers (≥10 packyears) for at least 10 years (n=616, 68.3y, 29.9% female). Socioeconomic status was analyzed using education level and mortality was assessed over a follow-up period of 4.5 years. Analyses were performed using ANOVA and regression models. Results: Spirometric lung function did not differ between groups, whereas CO diffusing capacity and indicators of lung hyperinflation/air-trapping showed better values in the neversmoker group. In both groups, spirometric lung function depended on the education level, with better values for higher education. Quality of life and 6-MWD were significantly different in never-smokers as well as patients with higher education. Asthma, alpha-1-antitrypsin deficiency, and bronchiectasis were more often reported in never-smokers, and asthma was more often reported in patients with higher education. Higher education was also associated with reduced mortality (hazard ratio 0.46; 95% CI 0.22–0.98). Conclusion: Overall, in the COSYCONET COPD cohort, differences in functional status between never-smokers and long-time ex-smokers were not large. Compared to that, the dependence on education level was more prominent, with higher education associated with better outcomes, including mortality. These data indicate that non-smoking COPD patients’ socioeconomic factors are relevant and should be taken into account by clinicians.
DOI of the first publication: 10.2147/COPD.S273839
URL of the first publication:
Link to this record: urn:nbn:de:bsz:291--ds-374681
ISSN: 1178-2005
Date of registration: 30-Sep-2022
Faculty: M - Medizinische Fakultät
Department: M - Innere Medizin
Professorship: M - Prof. Dr. Robert Bals
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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