Tuberculosis and airflow obstruction: evidence from the PLATINO study in Latin America

Menezes, Ana Maria B.; Hallal, Pedro Curi; Pérez‐Padilla, Rogelio; Jardim, José Roberto; Muiño, Adriana; López, María Victorina; Valdívia, Gonzalo; de, María Montes; Tálamo, Carlos; Pertuzé, Julio; Victora, Cesar G

doi:10.1183/09031936.00083507

Cited by 217 publications

(208 citation statements)

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“…10 A history of pulmonary TB increased the risk of COPD about 4-fold in men and nearly 2-fold in women, even after adjustment for age, gender, education, ethnic origin, smoking status, exposure to dust and smoke, and respiratory morbidity in childhood. 11 As pulmonary TB remains a common disease in Hong Kong, it may be a significant contributor to airflow obstruction in COPD.…”

Section: Discussionmentioning

confidence: 99%

Severity of airflow limitation, co-morbidities and management of chronic obstructive pulmonary disease patients acutely admitted to hospital

Au¹,

Chan²

2013

Hong Kong Med J

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Objective To assess the disease spectrum, severity of airflow limitation, admission pattern, co-morbidities, and management of patients admitted for acute exacerbations of chronic obstructive pulmonary disease. Design Case series.Setting An acute regional hospital in Hong Kong.Patients Adult subjects admitted during January 2010 to December 2010 with the principal discharge diagnosis of chronic obstructive pulmonary disease. ResultsIn all, the records of 253 patients with physician-diagnosed chronic obstructive pulmonary disease were analysed. The majority were old (mean age, 78 years). The median number of admissions per patient for this condition in 2010 was two. About two thirds (64%) had had spirometry at least once. Mean forced expiratory volume in one second predicted was 55%. Almost 90% had moderate-to-very severe airflow limitation by spirometry. Overall, long-acting bronchodilators (beta agonists and/or antimuscarinics) were being prescribed for only 21% of the patients. ConclusionMost of the patients admitted to hospital for acute exacerbations of chronic obstructive pulmonary disease were old, had multiple co-morbidities, and the majority had moderate-to-severe airflow limitation by spirometry. Almost half of them (around 46%) had two or more admissions in 2010. Adherence to the latest treatment guidelines seemed inadequate, there being a low prescription rate of long-acting bronchodilators. Chronic obstructive pulmonary disease patients warranting emergency admissions are at risk of future exacerbations and mortality. Management by a designated multidisciplinary team is recommended. Severity of airflow limitation, co-morbidities and management of chronic obstructive pulmonary disease patients acutely admitted to hospital O R I G I N A L A R T I C L E LH Au HS Chan 區力行陳學深New knowledge added by this study • Almost 90% of chronic obstructive pulmonary disease (COPD) subjects with spirometry performed had moderate-to-very severe disease when hospital admission ensued. • About half of these patients had two or more admissions in 1 year.• Despite the severity of their illness, long-acting bronchodilators were underused by these Hong Kong COPD patients.• Long-term oxygen therapy and non-invasive ventilation (acute and long term) were used by significant numbers of patients with severe-to-very severe disease. Implications for clinical practice or policy• As many COPD patients warranting hospital admissions were already at high risk, preferably they should be managed by a multidisciplinary team in a designated respiratory or COPD ward.• Patients with a clinical diagnosis of COPD should have confirmatory spirometry.• Patients with moderate-to-severe COPD disease warrant planned interventions (including use of long-acting bronchodilators) to reduce future exacerbations and hospital admissions.• COPD patients with hypercapnic respiratory failure are at risk of mortality, and if feasible, should be managed by trained staff in a dedicated team.

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Section: Discussionmentioning

confidence: 99%

Severity of airflow limitation, co-morbidities and management of chronic obstructive pulmonary disease patients acutely admitted to hospital

Au¹,

Chan²

2013

Hong Kong Med J

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“…[2] In a number of large population-based cross-sectional studies, PTB has also been shown to be strongly associated with the presence of chronic airflow limitation (CAL). [3][4][5][6] In some studies, this association is almost as strong as that for cigarette smoking. [5][6][7] In a community-based study performed in South Africa (SA), 49.2% of adults aged ≥40 years who reported a history of PTB had evidence of CAL (Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 1 or higher).…”

Section: Researchmentioning

confidence: 95%

Obstructive pulmonary disease in patients with previous tuberculosis: Pathophysiology of a community-based cohort

et al. 2017

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Background. An association between chronic airflow limitation (CAL) and a history of pulmonary tuberculosis (PTB) has been confirmed in epidemiological studies, but the mechanisms responsible for this association are unclear. It is debated whether CAL in this context should be viewed as chronic obstructive pulmonary disease (COPD) or a separate phenotype. Objective. To compare lung physiology and high-resolution computed tomography (HRCT) findings in subjects with CAL and evidence of previous (healed) PTB with those in subjects with smoking-related COPD without evidence of previous PTB. Methods. Subjects with CAL identified during a Burden of Obstructive Lung Disease (BOLD) study performed in South Africa were studied. Investigations included questionnaires, lung physiology (spirometry, body plethysmography and diffusing capacity) and quantitative HRCT scans to assess bronchial anatomy and the presence of emphysema (<-950 HU), gas trapping (<-860 HU) and fibrosis (>-200 HU). Findings in subjects with a past history and/or HRCT evidence of PTB were compared with those in subjects without these features. Results. One hundred and seven of 196 eligible subjects (54.6%) were enrolled, 104 performed physiology tests and 94 had an HRCT scan. Based on history and HRCT findings, subjects were categorised as no previous PTB (NPTB, n=31), probable previous PTB (n=33) or definite previous PTB (DPTB, n=39). Subjects with DPTB had a lower diffusing capacity (Δ=-17.7%; p=0.001) and inspiratory capacity (Δ=-21.5%; p=0.001) than NPTB subjects, and higher gas-trapping and fibrosis but not emphysema scores (Δ=+6.2% (p=0.021), +0.36% (p=0.017) and +3.5% (p=0.098), respectively). Conclusions. The mechanisms of CAL associated with previous PTB appear to differ from those in the more common smoking-related COPD and warrant further study.

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“…Estos hallazgos, que relacionan la existencia de enfermedad obstructiva de la vía aérea por espirometría en pacientes con secuelas de tuberculosis pulmonar están de acuerdo con lo descrito previamente en otros estudios. (4,5,8,17,19,21,23,24,26,27).…”

Section: Discussionunclassified

Alteraciones espirométricas en pacientes con secuela de tuberculosis pulmonar

Llanos-Tejada

2011

Rev Med Hered

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Alteraciones espirométricas en pacientes con secuela de tuberculosis pulmonar.Alteraciones espirométricas en pacientes con secuela de tuberculosis pulmonar.Spirometrics alterations in patients with pulmonary tuberculosis sequelae. Félix Llanos-Tejada 1 RESUMENEl pulmón con secuela de tuberculosis es un diagnóstico frecuente de limitación en la función pulmonar que requiere estudio. Objetivo: Determinar las alteraciones espirométricas más frecuentes en pacientes con secuela de tuberculosis pulmonar que requirieron hospitalización, grado de severidad y la respuesta a broncodilatadores. Material y Métodos: Se realizó un estudio descriptivo transversal retrospectivo con revisión de los informes de espirometría realizadas durante el año 2007 en la Unidad de Función Pulmonar del Servicio de Neumología del Hospital Nacional Dos de Mayo. Resultados: Se revisaron 104 espirometrías. El promedio de edad fue 51,2 años. El motivo de hospitalización fue broncorrea infectada en 75%, disnea en 74,04% y hemoptisis en 30,77%. La CVF, VEF 1 , VEF 1 %CVF, CVIF% y FEF 25-75% , en promedio fue 109%; 72,9%, 57%, 59,7% y 31,4%, respectivamente. Se obtuvo patrón de normalidad ventilatoria en 16,35%; obstructivo en 79,81% y no-obstructivo (restrictivo) en 13,46%. En los pacientes con patrón obstructivo, la presencia de reversibilidad total a los broncodilatadores se obtuvo en 28,92%. Se encontró una correlación negativa (p<0,05) entre disnea y CIVF. Conclusiones: El patrón obstructivo sin reversibilidad a broncodilatadores fue la alteración espirométrica más frecuente encontrada en pacientes con secuela de tuberculosis pulmonar. Existe una relación inversa la disnea y la CI. (Rev Med Hered 2010;21:77-83).PALABRAS CLAVE: Espirometría, secuela de tuberculosis pulmonar, obstrucción, tuberculosis. SUMMARYThe sequelae tuberculosis lung is a frequent diagnosis with lung function limitation that might have a study. Objective: To determine the spirometry pattern in the hospitalized patients and get theirs severity and bronchodilator answer. Material and Methods: It´s a descriptive, transversal retrospective study; we reviewed 104 spirometries. Results: The average age was 51,2. The reason to hospitalize was infectious bronchorrea in 75%, dispnea in 74.04% and hemoptysis in 30.77%. The FVC was 109%; FEV 1 72.9%; FEV 1 %FVC 57%; CVIF% 59.7%; FEF 25-75% , 31.4%. The spirometric results were normal in 16.35%; obstructive in 79.81% and non-obstructive (restrictive) in 13.46%. There was bronchodilator answer in 28.92% of the obstructive pattern. There was an inverse correlation (p<0.05) between dispnea and CIVF. Conclusions: The obstructive spirometry pattern without bronchodilator answer was the most frequent spirometric pattern in patient with sequelae tuberculosis lung. There is an inverse relation between dispnea and inspiratory capacity. (Rev Med Hered 2010;21:77-83).

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Tuberculosis and airflow obstruction: evidence from the PLATINO study in Latin America

Cited by 217 publications

References 25 publications

Severity of airflow limitation, co-morbidities and management of chronic obstructive pulmonary disease patients acutely admitted to hospital

Severity of airflow limitation, co-morbidities and management of chronic obstructive pulmonary disease patients acutely admitted to hospital

Obstructive pulmonary disease in patients with previous tuberculosis: Pathophysiology of a community-based cohort

Alteraciones espirométricas en pacientes con secuela de tuberculosis pulmonar

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