RT Journal Article
SR Electronic
T1 Predictive value of spirometry in early detection of lung disease in adults: a cohort study
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP bjgpopen20X101059
DO 10.3399/bjgpopen20X101059
A1 Lene Maria Ørts
A1 Bodil Hammer Bech
A1 Torsten Lauritzen
A1 Janus Laust Thomsen
A1 Niels Henrik Bruun
A1 Anders Løkke
A1 Annelli Sandbæk
YR 2020
UL http://bjgpopen.org/content/early/2020/08/04/bjgpopen20X101059.abstract
AB Background Spirometry is essential to identify cases with obstructive lung diseases (OLDs) in primary care. However, knowledge about the long-term prognostic outcome among younger individuals is sparse.Aim To describe the predictive value of spirometry among individuals in the age groups 30–49 years and 45–64 years.Design & setting A population-based cohort study supplied with data from Danish national registries.Method Spirometry was performed in 905 adults aged 30–49 years in 1991 and in 1277 adults aged 45–64 years in 2006. The participants were categorised into three groups: forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) <70, 70–75, and >75. They were followed throughout 2017 using Danish national registries. Lung disease was defined as fulfilling at least one of the following: two prescriptions for respiratory medicine were redeemed within a year; one lung-related contact to the hospital; or lung-related death.Results In the 1991 cohort, 21% developed lung diseases and in the 2006 cohort 17% developed lung diseases throughout 2017. The probability of developing lung disease if FEV1/FVC 70–75 was 35% (95% confidence interval [CI] = 25% to 44%) in the 1991 cohort and 23% (95% CI = 17% to 28%) in the 2006 cohort. The positive predicted value (PPV) was higher for both cohorts when focusing on smoking history and self-reported respiratory symptoms.Conclusion The initial spirometry has a high predictive value to identify cases of future lung diseases. In addition, the group with FEV1/FVC 70–75 had a high risk of developing lung diseases later in life, suggesting this group would be a meaningful target of special interest.