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Spirometry is not enough to diagnose COPD in epidemiological studies: a follow-up study.
- Source :
-
NPJ primary care respiratory medicine [NPJ Prim Care Respir Med] 2017 Nov 14; Vol. 27 (1), pp. 62. Date of Electronic Publication: 2017 Nov 14. - Publication Year :
- 2017
-
Abstract
- A hallmark of the diagnosis of chronic obstructive pulmonary disease (COPD) is the measurement of post-bronchodilator (post-BD) airflow obstruction (AO) by spirometry, but spirometry is not enough for the provision of a clinical diagnosis. In the majority of previous epidemiological studies, COPD diagnosis has been based on spirometry and a few clinical characteristics. The aim of our study was to identify outcomes in patients newly diagnosed with airflow obstruction (AO) based on a diagnostic work-up conducted as part of a population-based cross-sectional study in North-Western Russia. Spirometry was performed before (pre-BD) and after BD administration, and AO was defined using the FEV1/FVC <0.70 and FEV1/FVC <lower limit of normal cut-off values. Relevant symptoms were recorded. Participants with AO identified at baseline were then examined by a pulmonologist, including a clinical examination and second spirometry with BD test. Of the 102 participants with post-BD AO in the initial assessment, only 60.8% still had AO identified at the second examination; among these patients, the following final diagnoses were reported: COPD (n = 41), asthma (n = 5), asthma-COPD overlap syndrome (ACOS) (n = 4) and likely ACOS (n = 5). Of the 65 participants with pre-BD AO, 23.1% had post-BD AO at the second assessment, and these patients had been diagnosed with COPD (n = 12), asthma (n = 1), ACOS (n = 1), likely ACOS (n = 1). Serial spirometric assessments complemented by a comprehensive clinical evaluation are recommended in new epidemiological studies.
- Subjects :
- Bronchodilator Agents therapeutic use
Cross-Sectional Studies
Female
Follow-Up Studies
Forced Expiratory Volume drug effects
Humans
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive drug therapy
Pulmonary Disease, Chronic Obstructive epidemiology
Russia epidemiology
Vital Capacity drug effects
Pulmonary Disease, Chronic Obstructive diagnosis
Spirometry
Subjects
Details
- Language :
- English
- ISSN :
- 2055-1010
- Volume :
- 27
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- NPJ primary care respiratory medicine
- Publication Type :
- Academic Journal
- Accession number :
- 29138407
- Full Text :
- https://doi.org/10.1038/s41533-017-0062-6