1393
Scholars Journal of Applied Medical Sciences (SJAMS) ISSN 2320-6691 (Online)
Sch. J. App. Med. Sci., 2014; 2(4D):1393-1396 ISSN 2347-954X (Print)
©Scholars Academic and Scientific Publisher
(An International Publisher for Academic and Scientific Resources)
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Research Article
Evaluate the Use of Spirometry for Diagnosis of COPD and Assessment of Its
Severity
Deepak Giri
1*
, Ashwin Rajbhoj
1
, Amit Thopte
1
, Kulbhushan Marathe
1
, Sandip Patel
1
, M. A. Ghanekar
2
1
Post Graduate Resident, Department of Medicine, PDVVPF’s Medical College and Dr. Vikhe Patil Hospital, Vilad
Ghat, Ahmednagar
2
Professor and Head, Department of Medicine, PDVVPF’s Medical College and Dr. Vikhe Patil Hospital, Vilad Ghat,
Ahmednagar
*Corresponding author
Dr. Deepak Giri
Email:
Abstract: The Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) has recommended spirometry as
the gold standard for diagnosis of COPD in symptomatic individuals through spirometric testing that demonstrates
irreversible airflow obstruction. Spirometry for case-finding diagnosis of all adults with persistent respiratory symptoms
or having a history of exposure to pulmonary risk factors has been recommended in primary care settings for all current
and former smokers who have persistent respiratory symptoms. The aim of this study was to evaluate the use of
spirometry for diagnosis of COPD and assessment of its severity. A total of 50 subjects with pre-bronchodilator air flow
obstruction underwent reversibility testing. Of these, 40 (80%) subjects had persistent airflow obstruction while 10 (20%)
were no longer obstructed. For COPD patients, the Mean ± SD age was 58 ± 11 yrs. Of which 21 were current smokers;
and the remaining 13 were ex-smokers. The Mean ± SD cigarettes smoked were 42 ± 29 pack-yrs. The Mean ± SD FEV
1
was 1.35 ± 0.52 L (55 ± 17% of predicted) and Mean ± SD FEV
1
/FVC ratio was 0.55 ± 0.09 in these patients. These
patients were classified according to GOLD classification in which 18 patients had severe, 11 patients had moderate, and
2 patients had mild and very severe COPD. Spirometry in addition to clinical examination improves COPD diagnostic
accuracy compared to clinical examination alone and it is a useful diagnostic tool in individuals with symptoms
suggestive of possible COPD.
Keywords: Chronic obstructive pulmonary disease, Asthma, Spirometry, FEV1/FEV, Smokers, Bronchodilator.
INTRODUCTION
It is aptly said that the patients of COPD have less
years in their life and less life in their years and this
disease is now a major concern for quality of life of the
individual.
COPD kills more than 3 million people every year,
making it the 4
th
largest cause of death in the world [1].
It has been estimated that by the year 2030, COPD will
become the third biggest cause of death. Half a million
people die every year due to COPD in India, which is
over 4 times the number of people who die due to
COPD in USA and Europe [2]. According to a report
published by the Maharashtra State Health Resource
Centre, COPD is the leading cause of death in
Maharashtra, causing more deaths than those due to
ischemic heart disease, stroke and diabetes all put
together [3].
The Global Initiative for Chronic Obstructive
Pulmonary Disease (GOLD) has recommended
spirometry as the gold standard for diagnosis of COPD
in symptomatic individuals through spirometric testing
that demonstrates irreversible airflow obstruction [4].
Spirometry for case-finding diagnosis and management
of all adults with persistent respiratory symptoms or
having a history of exposure to pulmonary risk factors
has been recommended in primary care settings for all
current and former smokers as well as never smokers
who have persistent respiratory symptoms or have
history of exposure to other COPD risk factors [5].
Role of spirometry in COPD requires basic
understanding of spirometry, its importance in the
management of COPD with knowledge of how to
perform spirometry correctly and its interpretation
(Chart). American Thoracic Society and European
Respiratory Society guidelines (ATS/ERS guidelines)
are used for acceptable and reproducible spirometry [6].
The United States Preventive Services Task Force, an
independent panel of experts in primary care and
prevention suggest spirometry evaluation in a person
presenting with shortness of breath, chronic cough,