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Predictive value of prebronchodilator and postbronchodilator spirometry for COPD features and outcomes
Spyridon Fortis1,2, Michael Eberlein1, Dimitris Georgopoulos2,3
1Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
BMJ Open Respiratory Research
|February 14, 2018
Summary
Postbronchodilator spirometry better predicts chronic obstructive pulmonary disease (COPD) features and mortality risk than prebronchodilator spirometry. This finding aids in more accurate COPD diagnosis and management strategies.
Area of Science:
- Pulmonary Medicine
- Respiratory Research
- Clinical Diagnostics
Background:
- Chronic Obstructive Pulmonary Disease (COPD) diagnosis relies on spirometry.
- The predictive value of prebronchodilator versus postbronchodilator spirometry for COPD outcomes requires further comparison.
Purpose of the Study:
- To compare the predictive capabilities of prebronchodilator and postbronchodilator spirometry for COPD features and clinical outcomes.
- To determine which spirometric measurement provides more accurate predictions for disease progression and mortality.
Main Methods:
- Analysis of COPDGene data from 10,192 subjects with a history of smoking.
- Development of regression models using prebronchodilator airflow obstruction (PREO) and postbronchodilator airflow obstruction (POSTO) as independent variables.
- Comparison of model performance using the Akaike information criterion (AIC) to assess predictive accuracy.
Main Results:
- Higher COPD prevalence was observed using PREO compared to postbronchodilator measurements.
- Both prebronchodilator and postbronchodilator spirometry correlated with chronic bronchitis, dyspnea, exercise capacity, and radiographic findings.
- Models incorporating postbronchodilator spirometry demonstrated superior predictive performance for COPD features and mortality risk compared to prebronchodilator measures.
Conclusions:
- Postbronchodilator spirometry appears to be a more accurate predictor of COPD features and long-term outcomes.
- These findings suggest that postbronchodilator spirometry should be prioritized for comprehensive COPD assessment and prognosis.
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