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Reference values for spirometry in elderly individuals: a cross-sectional study of different reference equations.

Joana Belo1,2, Teresa Palmeiro2, Iolanda Caires2

  • 1Lisbon School of Health Technology, Polytechnic Institute of Lisbon, Lisbon, Portugal.

Multidisciplinary Respiratory Medicine
|January 18, 2018
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Summary

Different spirometry reference equations significantly impact respiratory function test results in the elderly. Choosing the correct equation is crucial for accurate interpretation of lung function, including airway obstruction and restrictive defects.

Keywords:
ECSCElderlyGLINHANES IIIReference eqs.Spirometry

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Area of Science:

  • Pulmonary Medicine
  • Respiratory Physiology
  • Geriatric Medicine

Background:

  • Spirometry is essential for assessing respiratory function.
  • Interpreting spirometry requires comparing patient data to reference values from specific populations.
  • Previous spirometry reference equations exist, but their applicability in diverse elderly populations requires investigation.

Purpose of the Study:

  • To compare spirometry reference values derived from National Health and Nutrition Assessment Survey (NHANES III), European Coal and Steel Community (ECSC), and Global Lung Initiative (GLI) equations.
  • To evaluate the impact of these different reference equations on the interpretation of spirometry results in an elderly cohort.

Main Methods:

  • Elderly participants from a geriatric study meeting inclusion criteria underwent spirometry.
  • Spirometry was conducted following international guidelines.
  • Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and the FEV1/FVC ratio were analyzed as percentages of predicted values, with the lower limit of normal calculated.

Main Results:

  • The Global Lung Initiative (GLI) equations yielded the lowest forced vital capacity (%FVC) and forced expiratory volume in 1 second (%FEV1) values.
  • The National Health and Nutrition Assessment Survey (NHANES III) equations resulted in a higher FEV1/FVC ratio compared to GLI and European Coal and Steel Community (ECSC) equations.
  • The prevalence of airway obstruction was highest with ECSC equations, while GLI equations indicated a higher prevalence of restrictive lung defects.

Conclusions:

  • Significant discrepancies exist in spirometry reference values and test results when using NHANES III, ECSC, and GLI equations.
  • The choice of spirometry reference equation demonstrably influences the interpretation of lung function, including the diagnosis of airway obstruction and restrictive patterns.