Comparison of Tucson and Cracow Longitudinal Studies: Results (Part 4)

Symptoms and Final FEV1
Although the final FEV1 was related to most of the symptoms when they were considered separately, not all associations remained significant when analyzed simultaneously with other symptoms (Table 4). The most consistent effects were seen for the different status variables related to dyspnea and attacks of breathlessness, as were found in the analysis of initial FEV, level. In Tucson women, the latter symptom was not significant; rather, wheeze and the asthma syndrome were — ventolin inhalers. Besides dyspnea and “asthmatic-type” symptoms (attacks of breathlessness, wheeze, and asthma syndrome), final FEVX was significantly related to persistent or new chronic phlegm in Tucson men and women and to new chronic bronchitis in Cracow men. The pattern of the associations was not very consistent but, in most cases, the negative effects of persistent symptoms exceeded those of new symptoms, and both were greater than the effects, of remitting symptoms.
The analysis of interactions has shown that the reduction of final FE VL connected with the symptoms was usually significantly greater in nonsmokers, specifically in exsmokers who ceased smoking before the study, than in current smokers. For example, in Tucson women, the significant effects of new wheeze on final FEV1 was —0.33 L in exsmokers and -0.27 L (p<0.10) in never-smokers, but it was not significant in smokers (estimated regression coefficient b = + 0.11 L). However, the interactions could not be detected for a given symptom or its status category simultaneously in both cities or in both genders. No interactions were found in Tucson men. For Tucson women, interactions were seen for new wheeze and persistent dyspnea. For Cracow men, interactions were seen for new dyspnea; for Cracow women, interactions were seen for new attacks of breathlessness.

Table 4—Effects of Symptoms in Regression Models for FEV, Final Level (L)

Symptoms

Male Subjects

Female Subjects

Tucson

Cracow

Tucson

Crawcow

Coeff

SE

Coeff

SE

Coeff

SE

Coeff

SE

Chronic phlegm

Persistent

— 0.42

0.15

-0.10

0.13

New

-0.17

0.21

— 0.18

0.10

Remission

-0.08

0.11

-0.01

0.07

Chronic bronchitis

Persistent

-0.04

0.10

New

-0.16

0.06

Remission

— 0.03

0.06

Wheeze

Persistent

0.04

0.12

New

— 0.15

0.09

Remission

— 0.19

0.08

Attacks of

breathlessness

Persistent

— 0.52

0.15

— 0.45

0.16

-0.16

0.09

New

-0.43

0.23

— 0.13

0.09

-0.10

0.05

Remission

-0.21

0.11

-0.08

0.08

-0.07

0.06

Dyspnea

Persistent

-0.22

0.20

— 0.29

0.13

— 0.39

0.10

— 0.08

0.05

New

-0.20

0.17

— 0.28

0.07

— 0.32

0.08

— 0.08

0.04

Remission

— 0.35

0.19

-0.10

0.09

— 0.12

0.07

— 0.081

0.04

Asthma syndrome

Persistent

-0.41

0.15

New

0.03

0.11

Remission

0.03

0.10

R2, %

64.5

63.6

70.4

58.9

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