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The impact of deployment on COPD in active duty military personnel
Tokunbo Matthews1, Joseph Abraham2, Lisa L Zacher3
1Pulmonary Disease Service, Joint Base Elmendorf Richardson Hospital, 5955 Zeamer Avenue, JBER, AK 99506.
Purpose:
To identify trends in chronic obstructive pulmonary disease (COPD) diagnoses among active duty U.S. military personnel based on deployment history and whether International Classification of Disease, 9th edition (ICD-9) coding meet criteria for the diagnosis of COPD.
Methods:
A retrospective chart review using the electronic medical system was conducted for military personnel diagnosed with COPD based on ICD-9 codes for emphysema or chronic obstructive lung disease with at least three qualifying outpatient COPD-coded encounters. Clinical symptoms, smoking history, pulmonary function testing, and radiographs obtained during the diagnostic workup were reviewed. The established diagnosis of COPD was analyzed in relation to deployment.
Results:
A total of 371 patients were identified during the study period (2005-2009). Of these patients, 194 (52.3%) deployed, whereas 177 (47.7%) did not deploy to Southwest Asia since 2003. Thirty-four percent had no documented smoking history despite the diagnosis of COPD. Airway obstruction was identified by spirometry in only 67% of individuals diagnosed with COPD. No statistically significant differences in pulmonary function testing values were identified between those deployed and nondeployed individuals.
Conclusion:
Despite evidence of increased respiratory symptoms in deployed military personnel, the impact of deployment on increased diagnosis of COPD or severity of disease appears minimal.
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