Determinants of respiratory symptom development in patients with chronic airflow obstruction

Chang, Jung Hyun; Lee, Jin Hwa; Kim, Mi Kyoung; Kim, Sung Ja; Kim, Ki Hwan; Park, Jae Suck; Kim, Tae Hyung; Kim, Yu Ii; Lee, Eun Woo; Kim, Jong O.; Hong, Sang Bum; Kim, Dong Soon

doi:10.1016/j.rmed.2006.03.014

Cited by 7 publications

(9 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 1998, the term ‘silent obstruction’ was introduced as a clinical warning of the absence of symptoms in COPD patients 21,22 . The present survey also revealed a cohort of COPD patients with ‘silent obstruction’; 35.3% of the COPD patients had no chronic cough, sputum production or breathlessness, which was similar to the number in the Korean study, 19 but lower than that in the US study 20…”

Section: Discussionsupporting

confidence: 81%

“…However, these results were based on surveys of small population samples. Two nationwide surveys conducted in Korea and the USA indicated that 36.9% and 16.2% of COPD patients had no respiratory symptoms 19,20 . These results were much lower than the 70% of COPD patients identified in the present study, because the subjects enrolled were asymptomatic, and by definition had no symptoms of cough/phlegm or dyspnoea.…”

Section: Discussioncontrasting

confidence: 80%

See 1 more Smart Citation

Chronic obstructive pulmonary disease in the absence of chronic bronchitis in China

Lu¹,

Yao²,

Zhong

et al. 2010

Respirology

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 81%

Section: Discussioncontrasting

confidence: 80%

Chronic obstructive pulmonary disease in the absence of chronic bronchitis in China

Lu¹,

Yao²,

Zhong

et al. 2010

Respirology

View full text Add to dashboard Cite

show abstract

“…In this study, 71% of subjects with AL were asymptomatic at examination, which is slightly higher compared to other epidemiological studies, where 40%–60% of the subjects with AL were free of respiratory symptoms 6,20,21. A possible reason for this could be that the number of subjects with severe AL in this study was relatively small compared to the other studies.…”

Section: Discussioncontrasting

confidence: 65%

“…A possible reason for this could be that the number of subjects with severe AL in this study was relatively small compared to the other studies. In any case, from an early diagnostic point of view, respiratory symptoms do not always predict AL,22 and spirometry is essential for early detection of AL 6,20,21,23. Although spirometry has become more readily available in recent years, it is not yet used widespread for the diagnosis of CADs in both the epidemiological and primary care settings 8,9.…”

Section: Discussionmentioning

confidence: 99%

The association between risk of airflow limitation and serum uric acid measured at medical health check-ups

Fukuhara¹,

Saito²,

Sato³

et al. 2017

COPD

View full text Add to dashboard Cite

The prevalence of COPD and asthma is increasing all over the world; however, their morbidities are thought to be greatly underestimated because of unawareness of patients’ conditions and respiratory symptoms. Spirometry is useful for the early detection of COPD and asthma with airflow limitation (AL), although it is not yet widely used for screening in epidemiological and primary care settings. A simple predictive marker used in combination with spirometry for AL is expected to be established. In medical health check-ups, serum uric acid (s-UA) is measured when screening for gout and has recently been suggested to have an association with several respiratory disorders, including asthma and COPD. However, whether s-UA influences the development of AL remains unclear. Therefore, the aims of this study were to examine the relationship between AL and s-UA and to investigate s-UA as a potential auxiliary marker for predicting AL risk in medical health check-ups. A total of 8,662 subjects aged >40 years were included. They were administered a simple questionnaire and assessed using pulmonary function tests, blood pressure (BP) measurements, and blood samplings. One hundred and fifty-six subjects (1.8%) had AL, just 29% of whom had experienced respiratory symptoms. The subjects with AL had significantly higher s-UA levels compared with never-smoking subjects without AL. Forced expiratory volume in 1 second (FEV1) %predicted showed significant correlations with age, smoking index, body mass index (BMI), mean BP, white blood cells, hemoglobin A1c, s-UA, and high-density lipoprotein cholesterol. In multiple logistic regression analysis, s-UA, in addition to age, smoking index, respiratory symptoms, and BMI, was independently associated with AL. In conclusion, elevated s-UA levels, together with respiratory symptoms, high smoking index, and weight loss, may epidemiologically predict the development of AL risk.

show abstract

“…Previous studies showed that symptoms were nonspecific and poor predictors of COPD 46–48. This occurs because the symptoms of COPD considered are often seen in subjects with normal lung function 49.…”

Section: Discussionmentioning

confidence: 99%

Voluntary lung function screening to reveal new COPD cases in southern Italy

Capozzolo

Castellana

Dragonieri

et al. 2017

COPD

View full text Add to dashboard Cite

BackgroundUnderdiagnosis of COPD is a relevant issue, and most frequently involves patients at early stages of the disease. Physicians do not routinely recommend smokers to undergo spirometry, unless they are symptomatic.AimsTo investigate the effectiveness of voluntary lung function screening in bringing to light patients with previously unknown COPD and to evaluate the relationships among symptoms, smoking status, and airway obstruction.MethodsA voluntary screening study for COPD was conducted during two editions of the annual Fiera del Levante (2014 and 2015), an international trade fair in Bari. Subjects were eligible for the study if they fulfilled the following inclusion criteria: age ≥35 years, smoker/ex-smoker ≥5 pack-years (PYs), or at least one chronic respiratory symptom (cough, sputum production, shortness of breath, and wheezing). A free post-β2-agonist spirometry test was performed by trained physicians for each participant using portable spirometers. Post-β2-agonist forced expiratory volume in 1 second (FEV1):forced vital capacity ratio <0.7 was chosen to establish the diagnosis of COPD. Sensitivity, specificity, and negative and positive predictive values (NPVs and PPVs) of symptoms for the presence of obstruction were calculated.ResultsA total of 1,920 individuals were eligible for the study; 188 subjects (9.8%) met COPD criteria. There was a 10.4% prevalence of COPD in subjects with one or more symptoms who had never smoked or smoked ≤5 PYs. Among COPD patients, prevalence of symptoms increased in the presence of FEV1 <80%. COPD smokers were more symptomatic than smokers without COPD. Sensitivity and specificity in all subjects with one or more symptoms were 87% and 32%, respectively, whereas in smoker subgroups, sensitivity and specificity were 71% and 41% (≥5 PYs) and 74% and 35% (≥10 PYs), respectively. In all subjects, the presence of at least one symptom was associated with a low PPV for COPD of 11%, but a very high NPV (96%). These data did not change if the analysis was limited to smokers.ConclusionVoluntary public lung function screening programs in Italy are effective, and may detect a large number of undiagnosed subjects with COPD in early stages. In our population, COPD symptoms had low specificity and PPV, even considering smokers only.

show abstract

Determinants of respiratory symptom development in patients with chronic airflow obstruction

Abstract: In CAO, respiratory symptom development is significantly associated with low FEV1/FVC and the presence of hypertension.

Cited by 7 publications

References 21 publications

Chronic obstructive pulmonary disease in the absence of chronic bronchitis in China

Chronic obstructive pulmonary disease in the absence of chronic bronchitis in China

The association between risk of airflow limitation and serum uric acid measured at medical health check-ups

Voluntary lung function screening to reveal new COPD cases in southern Italy

Contact Info

Product

Resources

About