Pulmonary function testing in COPD: looking beyond the curtain of FEV1

Kakavas, Sotirios; Kotsiou, Ourania S.; Perlikos, Fotis; Mermiri, Maria; Mavrovounis, Georgios; Gourgoulianis, Konstantinos; Pantazopoulos, Ioannis

doi:10.1038/s41533-021-00236-w

Cited by 47 publications

(26 citation statements)

References 155 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies have shown that COPD patients with higher mMRC scores have higher emergency room and hospitalization rates, and that mMRC ≥ grade two in COPD patients is associated with higher healthcare and social costs [ 26 ]. Pulmonary function testing is a tool for diagnosing the degree of airflow obstruction in COPD [ 28 ], but FEV1 is not sufficient to measure the overall severity of COPD. However, FEV1 remains a useful reference for physicians to assess clinical severity or treatment.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Impact of the Age, Dyspnoea, and Airflow Obstruction (ADO) Index on the Medical Burden of Chronic Obstructive Pulmonary Disease (COPD)

Tsai

et al. 2022

JCM

View full text Add to dashboard Cite

There are currently no good indicators that can be used to predict the medical expenses of chronic obstructive pulmonary disease (COPD). This was a retrospective study that focused on the correlation between the age, dyspnoea, and airflow obstruction (ADO) index and the Charlson comorbidity index (CCI) on the medical burden in COPD patients, specifically, those of patients with complete ADO index and CCI data in our hospital from January 2015 to December 2016. Of the 396 patients with COPD who met the inclusion criteria, 382 (96.5%) were male, with an average age of 71.3 ± 8.4 years. Healthcare resource utilisation was positively correlated with the ADO index. A significant association was found between the ADO index and CCI of COPD patients (p < 0.001). In-hospitalization expenses were positively correlated with the CCI (p < 0.001). Under the same CCI, the higher the ADO score, the higher the hospitalisation expenses. The ADO quartiles were positively correlated with the number of hospitalisations (p < 0.001), hospitalisation days (p < 0.001), hospitalisation expenses (p = 0.03), and total medical expenses (p = 0.037). Findings from this study show that the ADO index can predict the medical burden of COPD.

show abstract

Section: Discussionmentioning

confidence: 99%

“…However, FEV1 remains a useful reference for physicians to assess clinical severity or treatment. In particular, decreased FEV1 was associated with exacerbation frequency [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of the Age, Dyspnoea, and Airflow Obstruction (ADO) Index on the Medical Burden of Chronic Obstructive Pulmonary Disease (COPD)

Tsai

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…Its good quality is influenced by a variety of factors, including subjects’ cooperation, sophisticated technologist, and precise instrumentation ( Culver et al, 2017 ). Sotirios ( Kakavas et al, 2021 ) et al believed that the calculation of the FEV 1 alone has limitations in detecting the underlying complexity of COPD disease. Our study also found that compared to the pulmonary function test, preoperative PaO 2 is a more objective and reliable parameter to evaluate the risk of postoperative respiratory failure in COPD patients.…”

Section: Discussionmentioning

confidence: 99%

General Anesthesia for Patients With Chronic Obstructive Pulmonary Disease and Postoperative Respiratory Failure: A Retrospective Analysis of 120 Patients

et al. 2022

View full text Add to dashboard Cite

Background: Chronic obstructive pulmonary disease (COPD) has been considered a risk factor for postoperative respiratory failure after general anesthesia. However, the association between COPD severity and postoperative respiratory failure among COPD patients is unknown. Our aim was to compare the prevalence of postoperative respiratory failure in COPD patients according to disease severity after general anesthesia.Methods: We retrospectively reviewed COPD patients undergoing spinal surgery with general anesthesia at our clinical center between January 2016 and January 2021. These subjects were divided into four groups (group I = mild COPD, group II = moderate COPD, group III = severe COPD, and group IV = very severe COPD) according to their preoperative lung function. The primary endpoint was a respiratory failure 1 week after surgery. The diagnosis of respiratory failure was made with the presence of one or more of the following criteria: prolonged ventilator dependence, unplanned postoperative intubation, and partial pressure of arterial oxygen (PaO2) ≤ 50 mmHg while the patient was breathing ambient air in the hospital. The extubation time, perioperative PaO2 and partial pressure of arterial carbon dioxide (PaCO2), postoperative lung infection, and length of hospitalization were also compared.Results: A total of 120 patients who underwent spinal surgery with general anesthesia were included in this retrospective study. Postoperative respiratory failure occurred in 0 (0.0%) patient in group I, 1 (1.5%) patient in group II, 1 (2.5%) patient in group III, and 1 (14.5%) patient in group IV 1 week after surgery (p = 0.219). The duration of anesthesia was 243.3 ± 104.3 min in group I, 235.5 ± 78.8 min in group II, 196.0 ± 66.3 min in group III, and 173.1 ± 63.7 min in group IV (p < 0.001). Preoperative PaO2, PaCO2, intraoperative oxygenation index [a ratio of PaO2 to fraction of inspired oxygen (FiO2)], and postoperative PaO2 were significantly different among the four groups (p < 0.001, 0.001, 0.046, <0.001, respectively). No significant differences among the four groups were seen in extubation time, pulmonary infection, or hospital stay (p = 0.174, 0.843, 0.253, respectively). The univariate analysis revealed that higher preoperative PaO2 was associated with a lower rate of postoperative respiratory failure (OR 0.83; 95% CI, 0.72 to 0.95; p = 0.007).Conclusion: The severity of COPD as assessed with GOLD classification was not associated with the development of postoperative respiratory failure. However, lower preoperative PaO2 was associated with greater odds of postoperative respiratory failure in COPD patients.

show abstract

“…Compared to COPD patients with pulmonary function in GOLD IV category, patients in GOLD I (OR=0.175, 95% CI=0.035–0.869, P =0.033) and GOLD II (OR=0.177, 95% CI=0.044–0.712, P= 0.015) were less likely to be in the “good health group“; compared to the “good health group”, COPD patients in Gold II (OR=0.217, 95% CI=0.063–0.754, P =0.016) category were also less likely to be in the “health low-level group”, suggesting that COPD patients in high Gold category reflect low levels of health, in line with the results of Ragland et al 27 Pulmonary function, as the gold standard for the assessment of COPD patients’ condition, reflects the severity of their condition. 36 It has been shown by some research studies that self-monitoring of respiration can help identify illness changes in their condition early. 37 Therefore, caregivers should pay attention to patients with poor pulmonary function and encourage them to pay close attention to their own airway function, as well as review their pulmonary function regularly to improve their quality of life.…”

Section: Discussionmentioning

confidence: 99%

A Longitudinal Study of Trajectories and Factors Influencing Patient-Reported Outcomes in Chronic Obstructive Pulmonary Disease

Cai¹,

Cui²,

Nong³

et al. 2022

COPD

View full text Add to dashboard Cite

Purpose To explore the trajectory of patient-reported outcomes and the factors influencing them in patients with COPD. Patients and Methods The study population, 236 patients with stable COPD who attended the outpatient clinic of the Department of Respiratory and Critical Care Medicine in a tertiary care hospital in Nanning City between October 2020 and November 2021, answered the modified patient-reported outcome scale for COPD (mCOPD-PRO). Patient-reported outcomes were investigated at the time of the patient’s outpatient visit (T1), 1 month after the visit (T2), 3 months after the visit (T3), and 6 months after the visit (T4). Latent class growth modeling was used to determine the number and shape of trajectories, and multinomial logistic regression analysis were used to explore influence factors of each class. Results COPD patients’ reported outcome trajectories were classified into 3 categories: health low-level group (14.80%), health risk group (54.70%), and good health group (30.50%). Logistic regression analysis showed that gender, BMI, smoking history, number of comorbidities, whether it was their first visit, and lung function classification were influential factors in patients’ reported outcome trajectories ( P <0.05). Female, obese, had a history of smoking, number of comorbid diseases >3, first diagnosis, and lung function class IV had a higher probability of entering the healthy low-level group. Conclusion COPD patients have poor self-reported health levels during the first 6 months after the outpatient visit, and there is group heterogeneity in patient-reported outcome trajectories; medical staff should give patients specific nursing interventions based on their current development of COPD, self-reported changes, and other relevant influencing factors.

show abstract

Pulmonary function testing in COPD: looking beyond the curtain of FEV1

Cited by 47 publications

References 155 publications

The Impact of the Age, Dyspnoea, and Airflow Obstruction (ADO) Index on the Medical Burden of Chronic Obstructive Pulmonary Disease (COPD)

The Impact of the Age, Dyspnoea, and Airflow Obstruction (ADO) Index on the Medical Burden of Chronic Obstructive Pulmonary Disease (COPD)

General Anesthesia for Patients With Chronic Obstructive Pulmonary Disease and Postoperative Respiratory Failure: A Retrospective Analysis of 120 Patients

A Longitudinal Study of Trajectories and Factors Influencing Patient-Reported Outcomes in Chronic Obstructive Pulmonary Disease

Contact Info

Product

Resources

About