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Indications for spirometry in outpatients with respiratory disease
M W Owens1, W M Anderson, R B George
1Department of Medicine, Louisiana State University, Shreveport.
Chest
|March 1, 1991
Summary
Routine spirometry in pulmonary clinics impacts clinical management plans for only 5% of patients. Changes are most likely in those with severe lung dysfunction or worsening symptoms, indicating spirometry
Area of Science:
- Pulmonary Medicine
- Clinical Diagnostics
Background:
- Spirometry is proposed as a routine vital sign for respiratory patients.
- Its impact on outpatient management requires further investigation.
Purpose of the Study:
- To assess the effect of spirometry on the clinical management plan (CMP) for outpatients with respiratory diseases.
Main Methods:
- 150 outpatients with various respiratory diseases underwent spirometry.
- Clinical management plans were formulated before and after spirometry results were available.
- Changes in CMP were analyzed based on spirometry findings and clinical status.
Main Results:
- Spirometry altered the CMP in only 5% of patients.
- Changes were significantly more likely in patients with severe ventilatory dysfunction (FEV1/FVC ≤ 0.40) or clinically deteriorating status.
- 16% of patients with severe dysfunction had altered CMPs versus 1.8% with mild/moderate dysfunction.
Conclusions:
- Spirometry is most beneficial in guiding management for outpatients with pulmonary disease who show clinical deterioration or have pre-existing severe lung dysfunction.
- It serves as a valuable supplement to history and physical examination in specific patient subgroups.