Chronic Obstructive Pulmonary Disease Spirometry Research Articles

Diagnostic spirometry in COPD is increasing, a comparison of two Swedish cohorts

Spirometry should be used to confirm a diagnosis of chronic obstructive pulmonary disease (COPD). This test is not always performed, leading to possible misdiagnosis. We investigated whether the proportion of patients with diagnostic spirometry has increased over time as well as factors associated with omitted or incorrectly interpreted spirometry. Data from medical reviews and a questionnaire from primary and secondary care patients with a doctors’ diagnosis of COPD between 2004 and 2010 were collected. Data were compared with a COPD cohort diagnosed between 2000 and 2003. Among 703 patients with a first diagnosis of COPD between 2004 and 2010, 88% had a diagnostic spirometry, compared with 59% (p < 0.001) in the previous cohort. Factors associated with not having diagnostic spirometry were current smoking (OR 2.21; 95% CI 1.36–3.60), low educational level (OR 1.81; 1.09–3.02) and management in primary care (OR 2.28; 1.02–5.14). The correct interpretation of spirometry results increased (75% vs 82%; p = 0.010). Among patients with a repeated spirometry, 94% had a persistent FEV1/FVC or FEV1/VC ratio <0.70.

Correlation of Six-Minute Walk Test and COPD Assessment Test (CAT) Scores with Spirometric Indices in Chronic Obstructive Pulmonary Disease Patients

Background: For chronic obstructive pulmonary disease spirometry assessment of post-bronchodilator FEV1 is critical for establishing the diagnosis, staging of the disease, predicting the outcome, and planning treatment. The six-minute walk test (6MWT) is an endurance test used to evaluate functional status of patients with cardiopulmonary disorders. CAT score is a well-established tool for determining the impact of COPD on one's health. Objective: To find out correlation between spirometric indices FEV1, FVC, FEV1/FVC, 6MWT and CAT Scores in COPD patients. Design: Cross sectional study Setting: Conducted from September 2019 to September 2021, for a period of 24 months in a tertiary care hospital in India Materials and Methods: In this study, the correlation between spirometric indices FEV1, FVC, FEV1/FVC, 6MWT and CAT Scores was analyzed in 100 patients diagnosed with COPD. Main outcome measures: 6MWT, CAT Scores and Spirometry values in COPD Sample size: 100 Results: Most patients were males(75%) between the ages of 61-70(36%). Majority were in Stage 3 COPD(55%), followed by stage 2 of GOLD staging(25%). Most of them had CAT score range of 21–30(51%), followed by 10–20(48%) and on 6MWT majority walked a distance of 301-400 meters(43%), followed by &gt; 400 meters(35%). The pulse rate and mean systolic blood pressure increased while mean SpO2 decreased post-6WMT with a statistically significant difference(P&lt;.001). The correlation of 6MWT and spirometry parameters shows there was a strong positive correlation of FEV1, FVC, and FEV1/FVC with 6MWT and correlation of CAT score and spirometry parameters shows there was a strong positive correlation of FEV1, FVC, and FEV1/FVC with 6MWT with a statistically significant difference (P&lt;.0001). There was a strong negative correlation between 6MWT and CAT score with a statistically significant difference (P&lt;.0001) Conclusion: The 6MWT and CAT score can be used as an effective alternative to determine the severity of COPD, according to the findings of this study especially in rural settings where access to spirometry is limited. Limitations: Majority of the individuals in our study had mild–moderate COPD severity, emphasizing that the 6MWT's validity and efficacy should be assessed in all COPD grades. Conflict of interest: None

Respiratory impedance is correlated with morphological changes in the lungs on three-dimensional CT in patients with COPD

The forced oscillation technique provides information concerning respiratory impedance, which comprises resistance and reactance of the respiratory system. However, its relationship with morphological changes of the lungs in chronic obstructive pulmonary disease (COPD) remains unclear. Respiratory impedance and spirometric data were evaluated in 98 patients with COPD and 49 reference subjects. Wall thickness (WT) and airway intraluminal area (Ai) of third- to sixth-generation bronchi, and percentage low-attenuation area with less than −950 HU (%LAA) of lungs were measured using three-dimensional computed tomography. COPD patients had higher respiratory impedance, decreased Ai, and increased %LAA compared with reference subjects. Indices of respiratory resistance and reactance and forced expiratory volume in 1 second (FEV1) were correlated with Ai, and the association between percent predicted FEV1 and Ai was predominant in distal bronchi. The difference in respiratory resistance between 5 Hz and 20 Hz (R5–R20) and FEV1/forced vital capacity ratio (FEV1/FVC) were correlated with WT. The %LAA was correlated with the FEV1/FVC ratio and respiratory reactance. Airway function measurements with the forced oscillation technique provide complementary information to spirometry in COPD.