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Hospitalizations and Mortality in the Lung Health Study

University of Manitoba, Winnipeg, Manitoba, Canada; University of Minnesota, Minneapolis, Minnesota; and Respiratory Sciences Center, Tucson, Arizona

Correspondence and requests for reprints should be addressed to John E. Connett, Ph.D., Biostatistics/CCBR, 2221 University Avenue SE, Suite 200, Minneapolis, MN 55414–3080. E-mail: john-c{at}biostat.umn.edu

This report deals with deaths and hospitalizations during the 5-year Lung Health Study, as documented by examination of appropriate records. There were 149 deaths (2.5%) during the study, caused largely by lung cancer and cardiovascular disease, particularly coronary heart disease. A total of 12.8% of participants were hospitalized, with cancer, cardiovascular disease, and nonmalignant respiratory disease accounting for 75% of hospitalizations. There were no significant differences among the original treatment groups for all-cause mortality, lung cancer, or hospitalizations for respiratory disease. Deaths and hospitalizations for cardiovascular disease and coronary artery disease were more common in the smoking intervention plus Atrovent inhaler (SI-A) group, which received ipratropium bromide, than in the smoking intervention plus placebo inhaler (SI-P) group, which received placebo, and the differences approached statistical significance. However, we were unable to find a dose effect, in that differences were not related to self-reported inhaler compliance. In the SI-A group, nine participants were hospitalized for supraventricular tachycardia as compared with two in the SI-P group, and SI-A participants with this condition were unusually compliant with their inhaled medication. When all participants were considered and smoking status considered as a time-dependent covariate, smoking cessation was associated with significant reductions in fatal or nonfatal cardiovascular disease and coronary artery disease.

Key Words: chronic obstructive pulmonary disease • anticholinergic • smoking • mortality • morbidity

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