The following is a summary of “Prevalence of abnormal spirometry in individuals with a smoking history and no known obstructive lung disease,” published in the MARCH 2023 issue of Pulmonology by Tran, et al.

According to recent data, chronic obstructive pulmonary disease (COPD) is more common than previously thought. These people run the risk of exacerbations and postponed treatment. For a study, researchers sought to determine who needs to have early spirometry, so they examined a population at risk for the prevalence of aberrant spirometry.

Data from the COPDGene study was examined. They considered participants who had smoked for ≥10 pack years. Those who had COPD, asthma, chronic bronchitis, emphysema, or were using inhalers were disqualified. These conditions can be self-reported or diagnosed by a doctor. Airflow obstruction (AFO) or preserved ratio impaired spirometry was used to characterize abnormal spirometry, and parsimonious multivariable logistic regression models were used to identify characteristics related to these conditions. A stepwise backward variable elimination procedure was used to choose the variables for the final model, minimizing the Akaike information criteria (AIC). Similarly, they evaluated variables related to incident COPD diagnosis during the 5-year follow-up period.

About 1,064 people out of 5,055 had undiagnosed AFO or 21%. While body mass index, female sex, and race of Black people were negatively linked with AFO, age, pack years, current smoking, and a history of acute bronchitis were positively associated. About 532 (19%) of the 2,800 participants who underwent a 5-year follow-up received an incident diagnosis of COPD. Atypical spirometry, recurrent productive cough, respiratory exacerbations during the follow-up period, and mMRC ≥2 were all associated risk variables. Age was negatively correlated.

In at-risk populations, the frequency of undiagnosed COPD is significant. At follow-up, they discovered several factors were connected to undetected COPD and incident COPD diagnoses. To enable early diagnosis and treatment, the findings can be utilized to identify those at risk for going undiagnosed for COPD.

Reference: resmedjournal.com/article/S0954-6111(23)00014-8/fulltext