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Pulm Med. 2011;2011:780215. doi: 10.1155/2011/780215. Epub 2011 Feb 6.

Subjects with Discordant Airways Obstruction: Lost between Spirometric Definitions of COPD.

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1
Department of Pulmonary Medicine, Paracelsus Private Medical University of Salzburg, 5020 Salzburg, Austria.

Abstract

BACKGROUND:

Since the FEV1/FVC ratio declines with age, using the fixed ratio of 0.70 leads to overdiagnosis of COPD in older populations and underdiagnosis among young adults.

OBJECTIVE:

To evaluate whether discordant obstructive cases (FEV1/FVC < 0.70 but ≥LLN) are a healthy population or have clinical features that would place them at increased risk.

METHODS:

We used post-bronchodilator spirometry data from the population-based Austrian Burden of Obstructive Lung Disease (BOLD) study. Those with post-bronchodilator FEV1/FVC ratio <LLN and <0.70 were defined as concordant obstructive cases. Participants with post-bronchodilator FEV1/FVC ratio ≥LLN but <0.70 were defined as discordant obstructive cases.

RESULTS:

Discordant obstructive cases were more likely to be older, male and never-smokers. Additionally they had less respiratory symptoms and less severe impairment of FEV1. However, discordant obstructive cases reported significantly more often a diagnosis of heart disease than subjects with normal lung function (27.2% vs 7.3%, P = .015).

CONCLUSION:

The clinical profile of discordant obstructive cases includes potentially important comorbid disease.

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