Long-acting beta-agonists reduce mortality of patients with severe and very severe chronic obstructive pulmonary disease: a propensity score matching study.

Pubmed ID: 23725215

Pubmed Central ID: PMC3674977

Journal: Respiratory research

Publication Date: June 3, 2013

Affiliation: Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Japan. nobuyuki_horita@yahoo.co.jp

MeSH Terms: Humans, Male, Female, Aged, Risk Factors, Survival Analysis, Proportional Hazards Models, Propensity Score, Severity of Illness Index, Incidence, Survival Rate, Pulmonary Disease, Chronic Obstructive, Japan, Adrenergic beta-Agonists

Authors: Horita N, Miyazawa N, Morita S, Kojima R, Ishigatsubo Y, Kaneko T, Kimura N

Cite As: Horita N, Miyazawa N, Morita S, Kojima R, Kimura N, Kaneko T, Ishigatsubo Y. Long-acting beta-agonists reduce mortality of patients with severe and very severe chronic obstructive pulmonary disease: a propensity score matching study. Respir Res 2013 Jun 3;14(1):62.

Studies:

Abstract

BACKGROUND: Long-acting beta-agonists were one of the first-choice bronchodilator agents for stable chronic obstructive pulmonary disease. But the impact of long-acting beta-agonists on mortality was not well investigated. METHODS: National Emphysema Treatment Trial provided the data. Severe and very severe stable chronic obstructive pulmonary disease patients who were eligible for volume reduction surgery were recruited at 17 clinical centers in United States during 1988-2002. We used the 6-10 year follow-up data of patients randomized to non-surgery treatment. Hazard ratios for death by long-acting beta-agonists were estimated by three models using Cox proportional hazard analysis and propensity score matching were measured. RESULTS: The pre-matching cohort was comprised of 591 patients (50.6% were administered long-acting beta-agonists. Age: 66.6 ± 5.3 year old. Female: 35.4%. Forced expiratory volume in one second (%predicted): 26.7 ± 7.1%. Mortality during follow-up: 70.2%). Hazard ratio using a multivariate Cox model in the pre-matching cohort was 0.77 (P = 0.010). Propensity score matching was conducted (C-statics: 0.62. No parameter differed between cohorts). The propensity-matched cohort was comprised of 492 patients (50.0% were administered long-acting beta-agonists. Age: 66.8 ± 5.1 year old. Female: 34.8%. Forced expiratory volume in one second (%predicted) 26.5 ± 6.8%. Mortality during follow-up: 69.1%). Hazard ratio using a univariate Cox model in the propensity-matched cohort was 0.77 (P = 0.017). Hazard ratio using a multivariate Cox model in the propensity-matched cohort was 0.76 (P = 0.011). CONCLUSIONS: Long-acting beta-agonists reduce mortality of severe and very severe chronic obstructive pulmonary disease patients.