Significant predictors of medically diagnosed chronic obstructive pulmonary disease in patients with preserved ratio impaired spirometry: a 3-year cohort study

Park, Hye Jung; Byun, Min Kwang; Rhee, Chin Kook; Kim, Kyungjoo; Kim, Hyung Jung; Yoo, Kwang-Ha

doi:10.1186/s12931-018-0896-7

Cited by 42 publications

(43 citation statements)

References 34 publications

(37 reference statements)

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“…Kim et al reported that COPD was found in approximately 23% of the participants aged 40 years or over with more than 10 pack-year smoking history (17). This finding was consistent with the findings by Hwang et al (15) forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) >0.7 with reduced FEV1 <80% predicted], they are most likely to develop COPD (18,19). Both raising awareness of COPD and increasing PFTs are important and necessary to manage and prevent the disease in the highrisk population.…”

Section: Copd Awarenesssupporting

confidence: 73%

The current status of chronic obstructive pulmonary disease awareness, treatments, and plans for improvement in South Korea: a narrative review

Park¹,

Yoo²

2021

J Thorac Dis

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The prevalence of chronic obstructive pulmonary disease (COPD) is high in South Korea which has remained virtually unchanged over the past few years. Other challenges related to COPD in South Korea include a low level of awareness of COPD, underutilization of pulmonary function tests (PFTs) and a low level of inhaler use. Continued efforts have been made to raise awareness of COPD in the general public and promote screening tests for the early detection of COPD patients for high-risk patients, which should be the primary object for better management of the disease. The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) and the Korea Disease Control and Prevention Agency (KDCA) have been working in tandem on numerous projects to resolve these issues. As the fruit of these efforts, a couple of projects are currently being carried out to add PFTs into the National Health Examination (NHE) of Korea as part of screening tests and improve the quality of COPD treatments in primary care settings. Raising public awareness of a chronic disease such as COPD requires collective efforts of academic societies and government. In addition, personalized education programs that are tailored to individual COPD patients is a necessity to raise adherence of treatment and self-management of COPD. The aim of this manuscript is to report the current status of COPD management in South Korea in hopes that it will help better treat and manage COPD in other nations coping with similar challenges.

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Section: Copd Awarenesssupporting

confidence: 73%

The current status of chronic obstructive pulmonary disease awareness, treatments, and plans for improvement in South Korea: a narrative review

Park¹,

Yoo²

2021

J Thorac Dis

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“…COPD is highly prevalent and a major cause of death worldwide 24 . However, only a small number (2-3%) of patients with COPD are diagnosed to have this condition by doctors in clinics in Korea 25 , as shown in world-wide 26 . COPD needs sustained follow-up, so primary care has a significant role in its management.…”

Section: Discussionmentioning

confidence: 99%

Frequent Outpatient Visits Prevent Exacerbation of Chronic Obstructive Pulmonary Disease

Park

Byun

Kim

et al. 2020

Sci Rep

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to April 30, 2015. A definition of COPD was used based on the diagnosis code and medication. Frequent visitors were defined as subjects who visited the outpatient clinic for COPD three or more times per year. Among 159,025 subjects, 117,483 (73.9%) were classified as frequent visitors. Frequent visitors underwent pulmonary function tests and used various inhalers more often than did infrequent visitors. the rates of copD exacerbation requiring admission to a general ward, emergency room, or intensive care unit were significantly lower in frequent visitors than in infrequent visitors. In multivariable analysis, frequent visits were identified as an independent factor preventing COPD exacerbation that required admission to a ward (odds ratio [OR], 0.387), emergency room, (OR, 0.558), or intensive care unit (OR, 0.39) (all P < 0.001). In conclusion, we showed frequent outpatient visits reduce the risk of COPD exacerbation by 45-60%.Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease of the airways that requires lifelong management 1 . A report from the Global Initiative for Chronic Obstructive Lung Disease have described routine patient follow-up as essential 2 . Lung function may worsen over time because of the natural history of COPD, so regular visits are needed to ensure frequent pulmonary function tests 3 . Symptoms and history of exacerbations should be monitored at these visits to adjust treatment, identify complications or comorbidities, and prevent acute exacerbations 4,5 . Frequent outpatient visits also offer patients an opportunity to improve their skills using inhalers, increase their knowledge of rehabilitation and nutritional support, and receive vaccination, all of which improve the clinical outcomes of COPD 6-9 . However, although there is good reason to believe that frequent outpatient visits have a prognostic benefit in COPD, there is insufficient scientific evidence to support this assumption.Until now, whether or not frequent outpatient visits have a prognostic benefit in COPD and how often patients should visit a hospital outpatient clinic to prevent exacerbations has never been investigated. The aim of this study was to determine whether or not frequent outpatient visits reduce the risk of exacerbation of COPD using data from a Korean national cohort study.

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“…Patients with preserved ratio impaired spirometry (PRISm), previously called restrictive pulmonary function [1,2], Global Initiative for Chronic Obstructive Lung Disease (GOLD)-unclassified [3] or the nonspecific pattern [4,5], do not meet the criteria for chronic obstructive pulmonary disease (COPD) but exhibit increased respiratory symptoms [1,2,6], increased cardiovascular comorbidity [7][8][9][10][11][12][13][14][15] and increased mortality [6,7,[16][17][18][19]. This neglected subgroup has often been excluded in research papers, though the existing studies to date estimate the prevalence of PRISm to range between 3.0% and 20% in adults [3,5,7,[18][19][20][21][22][23]. Few of these studies were conducted in the general population and they rarely performed repeated spirometry measurements.…”

Section: Introductionmentioning

confidence: 99%

“…Longitudinal studies of subjects with PRISm are scarce and have mostly been conducted in populations of current or past smokers. Some have suggested PRISm is a fluctuating state, serving as an intermediate phase between normal spirometry and COPD for a subset of individuals [2,3,5,18,20]. Others have identified risk factors for PRISm, which include female sex [3,18], smoking, advanced age, metabolic syndrome [24,25], a history of tuberculosis [26], systemic inflammation [4,[27][28][29], exposure to fine dust [30] and exposure to biomass cooking fuels [31].…”

Section: Introductionmentioning

confidence: 99%

Trajectory and mortality of preserved ratio impaired spirometry: the Rotterdam Study

et al. 2019

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Preserved ratio impaired spirometry (PRISm) is a heterogeneous condition but its course and disease progression remain to be elucidated. We aimed to examine its prevalence, trajectories and prognosis in the general population.In the Rotterdam Study (population-based prospective cohort) we examined prevalence, trajectories and prognosis of subjects with normal spirometry (controls; forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ≥0.7, FEV1 ≥80%), PRISm (FEV1/FVC ≥0.7, FEV1 <80%) and chronic obstructive pulmonary disease (COPD) (FEV1/FVC <0.7) at two study visits. Hazard ratios with 95% confidence intervals for mortality (until December 30, 2018) were adjusted for age, sex, body mass index, current smoking and pack-years.Of 5487 subjects (age 69.1±8.9 years; 7.1% PRISm), 1603 were re-examined after 4.5 years. Of the re-examined PRISm subjects, 15.7% transitioned to normal spirometry and 49.4% to COPD. Median lung function decline was highest in subjects with incident PRISm (FEV1 −92.8 mL·year−1, interquartile range (IQR) −131.9– −65.8 mL·year−1; FVC −93.3 mL·year−1, IQR −159.8– −49.1 mL·year−1), but similar in persistent PRISm (FEV1 −30.2 mL·year−1, IQR −67.9– −7.5 mL·year−1; FVC −20.1 mL·year−1, IQR −47.7–21.7 mL·year−1) and persistent controls (FEV1 −39.6 mL·year−1, IQR −64.3–−12.7 mL·year−1; FVC −20.0 mL·year−1, IQR −55.4–18.8 mL·year−1). Of 5459 subjects with informed consent for follow-up, 692 (12.7%) died during 9.3 years (maximum) follow-up: 10.3% of controls, 18.7% of PRISm subjects and 20.8% of COPD subjects. Relative to controls, subjects with PRISm and COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2–4 had increased all-cause mortality (PRISm: HR 1.6, 95% CI 1.2–2.0; COPD GOLD 2–4: HR 1.7, 95% CI 1.4–2.1) and cardiovascular mortality (PRISm: HR 2.8, 95% CI 1.5–5.1; COPD 2–4: HR 2.1, 95% CI 1.2–3.6). Mortality within <1 year was highest in PRISm, with patients often having cardiovascular comorbidities (heart failure or coronary heart disease; 70.0%).PRISm is associated with increased mortality and this population encompasses at least three distinct subsets: one that develops COPD during follow-up, a second with high cardiovascular burden and early mortality, and a third with persistent PRISm and normal age-related lung function decline.

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Significant predictors of medically diagnosed chronic obstructive pulmonary disease in patients with preserved ratio impaired spirometry: a 3-year cohort study

Cited by 42 publications

References 34 publications

The current status of chronic obstructive pulmonary disease awareness, treatments, and plans for improvement in South Korea: a narrative review

The current status of chronic obstructive pulmonary disease awareness, treatments, and plans for improvement in South Korea: a narrative review

Frequent Outpatient Visits Prevent Exacerbation of Chronic Obstructive Pulmonary Disease

Trajectory and mortality of preserved ratio impaired spirometry: the Rotterdam Study

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