Fractional Exhaled Nitric Oxide and Mortality in Asthma And/Or Chronic Obstructive Pulmonary Disease

16 Pages Posted: 25 Feb 2022

See all articles by Isaac Ikwu

Isaac Ikwu

Howard University - Howard University Hospital

Louis Nicolas

Howard University College of Medicine

Alem Mehari

Howard University - Howard University Hospital

Richard Gillum

Howard University

Abstract

Background: Little is known about FeNO as a predictor of mortality in persons with asthma or chronic obstructive pulmonary disease (COPD).

Objective: This study tested the hypotheses that FeNO level >=25ppb was associated with mortality in a national cohort of persons with asthma and COPD.

Methods: In the 2007-2012 National Health and Nutrition Examination Survey (NHANES), FeNO was measured using an electrochemical sensor. Mortality was determined through 2015. Weighted Cox proportional hazards survival analysis was performed taking the complex survey design into account using STATA V.17.ResultsAmong the 611 participants with current asthma, 5.16% died during the follow-up period. FeNO >=25ppb was associated with a hazard ratio (HR)of 0.20, (p=0.006, 95% CI:0.068-0.618) alone or with little change after controlling for confounding variables. Due to effect modification, the analysis was repeated in persons with or without a history of emergency department (ED) visits for asthma. In persons without ED visits FeNO >=25ppb was significantly associated with mortality HR 0.094, 95 CI 0.034 - 0.26, p< 0.001. In those with ED visits HR= 17.94, 95% CI 1.92 - 168.05, p= 0.013. Among 614 with COPD, FeNO >=25ppb was not associated with mortality.

Conclusion: In persons with current asthma at baseline, FeNO>=25ppb was associated with reduced hazard of mortality during follow up among those with no history of ED visits in the previous year. No significant association of FeNO with mortality was seen in persons with COPD.

Note:
Funding Information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Declaration of Interests: None.

Keywords: - Fractional exhaled Nitric oxide, Asthma, COPD, Mortality

Suggested Citation

Ikwu, Isaac and Nicolas, Louis and Mehari, Alem and Gillum, Richard, Fractional Exhaled Nitric Oxide and Mortality in Asthma And/Or Chronic Obstructive Pulmonary Disease. Available at SSRN: https://ssrn.com/abstract=4043745 or http://dx.doi.org/10.2139/ssrn.4043745

Isaac Ikwu (Contact Author)

Howard University - Howard University Hospital ( email )

2041 Georgia Avenue
Washington, DC 20060
United States

Louis Nicolas

Howard University College of Medicine ( email )

520 W St NW
Washington, DC 20059
United States

Alem Mehari

Howard University - Howard University Hospital ( email )

Richard Gillum

Howard University ( email )

2900 Van Ness Street, N.W.
Washington, DC 20008
United States

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