BackgroundIncreasing evidence suggests that sarcopenia and a higher systemic immune-inflammation index (SII) are linked with morbidity in patients with chronic obstructive pulmonary disease (COPD). However, whether these two conditions contribute to all-cause mortality in middle-aged and older patients with COPD or asthma is unclear. Therefore, we investigated the association between sarcopenia, SII, COPD, or asthma and all-cause mortality in a large-scale population-based setting.MethodsBetween 2009 and 2014, 4482 participants (aged>55 years, 57.3% female) from the population-based Rotterdam Study were included. COPD and asthma patients were clinically and spirometry-based diagnosed. Six study groups were defined according to the presence or absence of COPD or asthma and sarcopenia. Cox regression models were used to assess all-cause mortality in the study groups, adjusted for sex, age, BMI, SII, smoking, oral corticosteroid use and comorbidities. In addition, all participants were categorised into sex-specific quartiles of SII and mortality in these groups was compared.ResultsOver a median follow-up of 6.1 years (IQR 5.0–7.2), 466 (10.4%) persons died. Independent of the presence of sarcopenia, participants with COPD had a higher risk of all-cause mortality (HR: 2.13 [95% CI: 1.46 to 3.12], and HR: 1.70 [95% CI: 1.32 to 2.18]). Compared to lower SII levels, higher SII levels increased mortality risk even in people without sarcopenia, COPD or asthma.ConclusionMiddle-aged and older people with COPD, higher SII levels or sarcopenia had an independently increased mortality risk. Our study suggests prognostic usefulness of routinely evaluating sarcopenia and SII in older people with COPD or asthma.
Diet and 20-year chronic obstructive pulmonary disease mortality in middle-aged men from three European countries
