Document Detail


Predicting reduced TLC in patients with low FVC and a normal or elevated FEV1/FVC ratio.
MedLine Citation:
PMID:  20835593     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To use clinical and spirometry findings in order to distinguish between the restrictive and nonspecific patterns of pulmonary function test results in patients with low FVC and a normal or elevated FEV1/FVC ratio.
METHODS: We analyzed the pulmonary function test results of 211 adult patients submitted to spirometry and lung volume measurements. We used the clinical diagnosis at the time spirometry was ordered, together with various functional data, in order to distinguish between patients presenting with a "true" restrictive pattern (reduced TLC) and those presenting with a nonspecific pattern (normal TLC).
RESULTS: In the study sample, TLC was reduced in 144 cases and was within the normal range in 67. The most common causes of a nonspecific pattern were obstructive disorders, congestive heart failure, obesity, bronchiolitis, interstitial diseases, and neuromuscular disorders. In patients given a working diagnosis of pulmonary fibrosis, pleural disease, or chest wall disease, the positive predictive value (PPV) for restriction was >or= 90%. In males, an FVC <or= 60% of predicted had a PPV for restriction of 98.8%. In females, the restrictive pattern was found in 84.4% of those with an FVC <or= 50% of predicted. A difference of >or= 0% between the FEV1% and the FVC% had a PPV for restriction of 89.5%. After performing logistic regression, we developed a point scale for predicting the restrictive pattern.
CONCLUSIONS: In many patients with reduced FEV1, reduced FVC, and a normal FEV1/FVC ratio, the restrictive pattern can be identified with confidence through the use of an algorithm that takes the clinical diagnosis and certain spirometry measurements into account.
Authors:
Luiz Carlos D'Aquino; Sílvia Carla Sousa Rodrigues; João Adriano de Barros; Adalberto Sperb Rubin; Nelson Augusto Rosário Filho; Carlos Alberto de Castro Pereira
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia     Volume:  36     ISSN:  1806-3756     ISO Abbreviation:  J Bras Pneumol     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-09-13     Completed Date:  2011-05-13     Revised Date:  2011-10-11    
Medline Journal Info:
Nlm Unique ID:  101222274     Medline TA:  J Bras Pneumol     Country:  Brazil    
Other Details:
Languages:  eng; por     Pagination:  460-7     Citation Subset:  IM    
Affiliation:
Faculdade de Medicina, Universidade Regional de Joinville, Joinville, SC, Brasil.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Epidemiologic Methods
Female
Forced Expiratory Volume / physiology*
Humans
Lung Diseases / diagnosis*
Male
Middle Aged
Reference Values
Spirometry / methods,  standards*
Vital Capacity / physiology*
Young Adult

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