|Title:||Severity staging of chronic obstructive pulmonary disease: Differences in pre- and post-bronchodilator spirometry||Authors:||Lin S.-H.
|Issue Date:||2009||Journal Volume:||50||Journal Issue:||5||Start page/Pages:||672-676||Source:||Yonsei Medical Journal||Abstract:||
Purpose: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines for chronic obstructive pulmonary disease (COPD) uses the post-bronchodilator spirometry for diagnosis and severity staging. We evaluated differences in the severity classification of COPD, based on pre- and post-bronchodilator spirometry. Materials and Methods: From 2000 to 2004, 207 COPD patients who underwent spirometry before and after inhalation of 400 μg of fenoterol were analyzed. A responder to the bronchodilator test (BDT) was defined by the American Thoracic Society (ATS) as an increase in forced expiratory volume in one second (FEV1) or forced vital capacity ? 12% and ? 200 mL, and by the European Respiratory Society (ERS) as an increase in FEV1 ? 10% of the predicted value. COPD severity was classified according to the 2008 GOLD guidelines. Results: For the entire study population, the FEV1 increased by 11.8 ± 12.5% of baseline after BDT and 41.1% and 27.1% of subjects were classified as responders using the ATS and ERS criteria, respectively. Based on pre-BDT spirometry, 55, 85, 58, and 9 patients were classified as Stage I-IV COPD, respectively. Sixty-seven (32.4%) patients changed severity staging after BDT, including 20.0%, 28.2%, 44.8%, and 66.7% of pre-BDT patients Stages I through IV, respectively. More ATS or ERS BDT-responders had a change in severity staging than non-responders (52.9% vs. 18.9% and 62.5% vs. 21.2%, both p < 0.001). Conclusion: Our data suggest that the severity staging of COPD using pre-BDT spirometry might lead to significant differences as compared to staging, based on post-BDT spirometry, as recommended by the current GOLD guidelines. ? Copyright: Yonsei University College of Medicine 2009.
|ISSN:||0513-5796||DOI:||10.3349/ymj.2009.50.5.672||SDG/Keyword:||fenoterol; aged; article; bronchodilatation; bronchospirography; chronic obstructive lung disease; controlled study; disease classification; disease severity; female; forced expiratory volume; human; inhalation test; major clinical study; male; practice guideline; Bronchodilator Agents; Fenoterol; Forced Expiratory Volume; Humans; Practice Guidelines as Topic; Prognosis; Pulmonary Disease, Chronic Obstructive; Spirometry
|Appears in Collections:||醫學系|
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