Abstract
Altitude effect on COPD in SPIROMICS cohort
European respiratory journal, Vol.58(Suppl. 65), OA2554
09/05/2021
DOI: 10.1183/13993003.congress-2021.oa2554
Abstract
Studies suggest higher mortality in COPD patients residing at high altitude. Nevertheless, the impact of altitude on functional capacity and health status in COPD is unknown.
Within the SPIROMICS cohort, we compared COPD patients from sea level (Los Angeles & San Francisco, n=400), with those from high-altitude (Salt Lake City & Denver, >1250m altitude, n=310). Multivariable models were used to compare symptoms, exacerbation frequency, functional exercise capacity, percent emphysema, and health status.
The high-altitude group was younger with more current smokers, less asthma history, higher supplemental oxygen use, and a history of more acute exacerbations (AE). Adjusted for FEV1, age, sex, race, smoking status, and pack-years, the high-altitude group had more emphysema percentage by CT (+3.2%, CI 2.6-3.7%, p<0.001). High altitude was associated with shorter 6MWD (-67 m, CI -51m to -84m, P=<0.001), for more frequent CAT≥10 (OR 1.69, CI 1.16-2.47, p=0.006) and poorer health status (+4.4 SGRQ, CI +1.8-+7.1, score, p=0.001). Differences in 6MWD were maintained when controlled for supplemental oxygen use. Analyzing longitudinal outcomes adjusted for baseline AE and FEV1, the high-altitude group had more severe AE in the first year of follow up compared to the sea level group (IRR 2.47, CI 1.18-5.16, p=0.016). We found no difference in mortality, FEV1 decline, or progression of HRQoL score by SGRQ between groups.
Our results suggest that living with COPD at high altitude is associated with more emphysema and poorer functional capacity and health status in comparison to sea level habitation. Whilst more AE was observed in the first year of follow up, more research is needed to understand the impact of altitude on COPD outcomes.
Details
- Title: Subtitle
- Altitude effect on COPD in SPIROMICS cohort
- Creators
- Rajat Suri - University of California, Los AngelesDaniela Markovic - University of California, Los AngelesDonald P. Tashkin - University of California, Los AngelesChristopher B. Cooper - University of California, Los AngelesRobert Paine - University of UtahAndrew Freeman - University of UtahMehrdad Arjomandi - University of California, San FranciscoR. Graham Barr - Columbia UniversityRussell P. Bowler - National Jewish HealthRussell G. Buhr - University of California, Los AngelesJeffrey L. Curtis - University of Michigan–Ann ArborMark T. Dransfield - University of AlabamaM. Brad DrummondSpyridon Fortis - University of IowaMeiLan K. HanEric A. Hoffman - University of IowaVictor Kim - Temple UniversityWanda K. O'NealVictor E. Ortega - Wake Forest UniversityFernando J. Martinez - Cornell UniversityS.I. Rennard - University of Nebraska Medical CenterPrescott G. Woodruff - University of California, San FranciscoIgor Barjaktarevic - University of California, Los Angeles
- Resource Type
- Abstract
- Publication Details
- European respiratory journal, Vol.58(Suppl. 65), OA2554
- Publisher
- European Respiratory Society
- DOI
- 10.1183/13993003.congress-2021.oa2554
- ISSN
- 0903-1936
- eISSN
- 1399-3003
- Language
- English
- Date published
- 09/05/2021
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Internal Medicine; Radiology; Pulmonary, Critical Care, and Occupational Medicine
- Record Identifier
- 9984528111602771
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