An updated comparison of standard and novel FEV1 indices’ association with all-cause mortality

Stephen T Russell, Mohleen Kang and Jordan A Kempker

PLOS ONE, 2025, vol. 20, issue 5, 1-9

Abstract: Rationale: Current recommendations for defining FEV1 abnormalities are based on Z-score cutoffs. Alternative approaches may better correlate with patient-related outcomes, including mortality. Objective: This study evaluates the association between FEV1 value and mortality in six FEV1 indices in a large, U.S based cohort. Methods: This is a cohort of 2007–2012 National Health and Nutrition Examination Study (NHANES) participants with spirometry and linked mortality data through 2019. We transformed FEV1 values to the following indices: raw FEV1, FEV1-Z scores (FEV1-Z), FEV1-Percent Predicted (FEV1-PP), FEV1/Height2 (FEV1/Ht2), FEV1/Height3 (FEV1/Ht3), and FEV1-Q. We compared association with all-cause mortality between lowest and highest FEV1 deciles of each index using Cox Proportional Hazards models. Two sensitivity analyses were performed, one after applying NHANES sample weighting and one including lower quality spirometry. A subgroup analysis of participants with airflow obstruction, defined as FEV1/FVC ≤ LLN, was performed. Results: Of the 12,994 included participants, 971 (7.5%) had died. The majority (56.2%) were nonsmokers and 13.2% had an FEV1/FVC

Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0323681

DOI: 10.1371/journal.pone.0323681

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