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Updated: Jan 15, 2026

Employing the Forced Oscillation Technique for the Assessment of Respiratory Mechanics in Adults
Published on: February 9, 2022
Prevalence, risk factors, and clinical implications of failed spirometry in adults: Results from NHANES 2007-2012
Cuiqiong Dai1, Lifei Lu1, Zihui Wang1
1State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & Guangzhou Institute of Respiratory Health & National Center for Respiratory Medicine & Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China.
Background And Research Question:
Some participants inevitably fail spirometry testing and we aimed to assess the prevalence, risk factors, chronic respiratory symptoms, health status, and all-cause mortality outcomes associated with failed spirometry.
Methods:
Using NHANES 2007-2012 data, we categorized participants into three groups: those with failed spirometry (FS-participants), those with qualified spirometry without COPD (QS-non-COPD), and those with qualified spirometry and COPD (QS-COPD). We assessed the prevalence and risk factors associated with FS-participants and compared clinical implications among the three groups.
Results:
The prevalence of FS-participants was 4.8%. Key risk factors included older age, being male, non-Hispanic Black ethnicity, lower socioeconomic status, self-reported emphysema, and increased frailty. After adjustment, FS-participants had higher odds of shortness of breath, wheezing, and dry cough at night (all P values < 0.05). They also faced a greater risk of all-cause mortality (HR: 1.51, 95% CI: 1.22 to 1.86; p < 0.001) compared to the QS-non-COPD group, a risk similar to that of the QS-COPD group (HR: 1.05, 95% CI: 0.82 to 1.27; p = 0.675).
Conclusion:
Failed spirometry is common among adults and correlates with increased respiratory symptoms and higher all-cause mortality risk, indicating the need for targeted attention.
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