Lung volume indices predict morbidity in smokers with preserved spirometry

Thorax
Siyang ZengMehrdad Arjomandi

Abstract

Abnormal lung volumes that reflect air trapping are common in COPD. However, their significance in smokers with preserved spirometry (normal FEV1 to FVC ratio) is unclear. Using the Veterans Administration Informatics and Computing Infrastructure database, we identified 7479 patients at risk for COPD (ever smokers >40 years of age without restrictive lung disease) who had preserved spirometry and concomitant lung volume measurements, and examined their subsequent health records for clinical diagnoses of COPD, healthcare utilisation, follow-up spirometry and mortality. Air trapping was prevalent, with 31% of patients having residual volume to total lung capacity ratio (RV:TLC) greater than the upper limit of normal (ULN). RV:TLC varied widely from 14% to 77% (51% to 204% of predicted) across the normal ranges of FEV1:FVC and FEV1. Patients with RV:TLC greater than the ULN were more likely to receive subsequent clinical diagnoses of COPD (HR (95% CI)=1.55 (1.42 to 1.70), p<0.001) and had higher all-cause mortality (HR (95% CI)=1.41 (1.29 to 1.54), p<0.001). They had higher rates of respiratory medication prescriptions and hospital and intensive care unit admissions. Other air trapping and static hyperinflation indices showed simi...Continue Reading

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Citations

Dec 21, 2019·Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia·Jonathan Jerias FernandezSílvia Carla Sousa Rodrigues
Aug 24, 2019·The European Respiratory Journal·Mehrdad ArjomandiUNKNOWN SPIROMICS Investigators
Oct 30, 2020·International Journal of Chronic Obstructive Pulmonary Disease·Michela D'AscanioAlberto Ricci
Oct 30, 2020·Journal of Clinical Medicine·Joon Young Choi, Chin Kook Rhee
Dec 4, 2020·European Respiratory Review : an Official Journal of the European Respiratory Society·Maria Eugenia Laucho-Contreras, Mark Cohen-Todd

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