Spirometry for patients in hospital and one month after admission with an acute exacerbation of COPD
Open Access
- 1 October 2011
- journal article
- Published by Informa UK Limited in International Journal of Chronic Obstructive Pulmonary Disease
- Vol. 6, 527-532
- https://doi.org/10.2147/COPD.S24133
Abstract
Aim: To assess whether spirometry done in hospital during an admission for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is clinically useful for long-term management. Methods: Patients admitted to hospital with a clinical diagnosis of AECOPD had spirometry post-bronchodilator at discharge and approximately 4 weeks later. Results: Spirometry was achieved in less than half of those considered to have AECOPD. Of 49 patients who had spirometry on both occasions, 41 met the GOLD criteria for COPD at discharge and 39 of these met the criteria at 1 month. For the 41, spirometry was not statistically different between discharge and 1 month but often crossed arbitrary boundaries for classification of severity based on FEV1. The eight who did not meet GOLD criteria at discharge were either misclassified due to comorbidities that reduce FVC, or they did not have COPD as a cause of their hospital admission. Conclusion: Spirometry done in hospital at the time of AECOP is useful in patients with a high pre-test probability of moderate-to-severe COPD. Small changes in spirometry at 1 month could place them up or down one grade of severity. Spirometry at discharge may be useful to detect those who warrant further investigation.Keywords
This publication has 14 references indexed in Scilit:
- Exacerbations of chronic obstructive pulmonary diseaseEuropean Respiratory Journal, 2007
- Variability of Spirometry in Chronic Obstructive Pulmonary DiseaseAmerican Journal of Respiratory and Critical Care Medicine, 2006
- Physiological changes during symptom recovery from moderate exacerbations of COPDEuropean Respiratory Journal, 2005
- Standardisation of spirometryEuropean Respiratory Journal, 2005
- Exacerbations of COPD Diagnosed in Primary Care: Changes in Spirometry and Relationship to SymptomsCOPD: Journal of Chronic Obstructive Pulmonary Disease, 2005
- Minimal Clinically Important Differences in COPD Lung FunctionCOPD: Journal of Chronic Obstructive Pulmonary Disease, 2005
- The Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity Index in Chronic Obstructive Pulmonary DiseaseNew England Journal of Medicine, 2004
- Is there any correlation between the ATS, BTS, ERS and GOLD COPD's severity scales and the frequency of hospital admissions?Respiratory Medicine, 2004
- Canadian Thoracic Society Recommendations for Management of Chronic Obstructive Pulmonary Disease – 2003Canadian Respiratory Journal, 2003
- Spirometric Reference Values from a Sample of the General U.S. PopulationAmerican Journal of Respiratory and Critical Care Medicine, 1999