|
KMID : 0311120090500050672
|
|
Yonsei Medical Journal
2009 Volume.50 No. 5 p.672 ~ p.676
|
|
|
Severity Staging of Chronic Obstructive Pulmonary Disease: Differences in Pre- and Post-Bronchodilator Spirometry
|
|
Lin Sheng-Hsiang
Kuo Ping-Hung
Kuo Sow-Hsong
Yang Pan-Chyr
|
|
|
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.
|
|
|
KEYWORD
|
|
|
Bronchodilator test, chronic obstructive pulmonary disease, severity staging
|
|
|
FullTexts / Linksout information
|
|
 
|
|
|
Listed journal information
|
|
   
|
|