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Consequences of Using Post- or Prebronchodilator Reference Values in Interpreting Spirometry.
- Source :
- American Journal of Respiratory & Critical Care Medicine; 8/15/2023, Vol. 208 Issue 4, p461-471, 11p
- Publication Year :
- 2023
-
Abstract
- Rationale: Postbronchodilator spirometry is used for the diagnosis of chronic obstructive pulmonary disease. However, prebronchodilator reference values are used for spirometry interpretation. Objectives: To compare the resulting prevalence rates of abnormal spirometry and study the consequences of using preor postbronchodilator reference values generated within SCAPIS (Swedish CArdioPulmonary bioImage Study) when interpreting postbronchodilator spirometry in a general population. Methods: SCAPIS reference values for postbronchodilator and prebronchodilator spirometry were based on 10,156 and 1,498 never-smoking, healthy participants, respectively. We studied the associations of abnormal spirometry, defined by using pre- or postbronchodilator reference values, with respiratory burden in the SCAPIS general population (28,851 individuals). Measurements and Main Results: Bronchodilation resulted in higher predicted medians and lower limits of normal (LLNs) for FEV<subscript>1</subscript>/FVC ratios. The prevalence of postbronchodilator FEV<subscript>1</subscript>/FVC ratio lower than the prebronchodilator LLN was 4.8%, and that of postbronchodilator FEV<subscript>1</subscript>/FVC lower than the postbronchodilator LLN was 9.9%, for the general population. An additional 5.1% were identified as having an abnormal postbronchodilator FEV<subscript>1</subscript>/FVC ratio, and this group hadmore respiratory symptoms, emphysema (13.5% vs. 4.1%; P,0.001), and self-reported physician-diagnosed chronic obstructive pulmonary disease (2.8% vs. 0.5%, P,0.001) than subjects with a postbronchodilator FEV<subscript>1</subscript>/FVC ratio greater than the LLN for both pre- and postbronchodilation. Conclusions: Pre- and postbronchodilator spirometry reference values differ with regard to FEV<subscript>1</subscript>/FVC ratio. Use of postbronchodilator reference values doubled the population prevalence of airflow obstruction; this was related to a higher respiratory burden. Using postbronchodilator reference values when interpreting postbronchodilator spirometry might enable the identification of individuals with mild disease and be clinically relevant. [ABSTRACT FROM AUTHOR]
- Subjects :
- REFERENCE values
SPIROMETRY
CHRONIC obstructive pulmonary disease
Subjects
Details
- Language :
- English
- ISSN :
- 1073449X
- Volume :
- 208
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- American Journal of Respiratory & Critical Care Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 169981084
- Full Text :
- https://doi.org/10.1164/rccm.202212-2341OC