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Fixed ratio or lower limit of normal as cut-off value for FEV1/VC: An outcome study.

Wollmer, Per LU and Engström, Gunnar LU (2013) In Respiratory Medicine
Abstract
There is no consensus on the appropriate cut-off level for the ratio between forced expiratory volume and vital capacity (FEV1/VC) for the diagnosis of chronic obstructive pulmonary disease (COPD). Application of a fixed ratio of 0.7 carries the risk of false positive diagnoses in elderly subjects and false negative diagnoses in younger subjects. The use of the lower limit of normal (LLN) of an individually predicted value should eliminate this problem. There is insufficient information about the outcome of elderly subjects with an FEV1/VC < 0.7 but above the LLN. We report lung function (spirometry and lung clearance index, LCI), mortality and risk of cardiac events in relation to FEV1/VC in a population-based sample of men examined at... (More)
There is no consensus on the appropriate cut-off level for the ratio between forced expiratory volume and vital capacity (FEV1/VC) for the diagnosis of chronic obstructive pulmonary disease (COPD). Application of a fixed ratio of 0.7 carries the risk of false positive diagnoses in elderly subjects and false negative diagnoses in younger subjects. The use of the lower limit of normal (LLN) of an individually predicted value should eliminate this problem. There is insufficient information about the outcome of elderly subjects with an FEV1/VC < 0.7 but above the LLN. We report lung function (spirometry and lung clearance index, LCI), mortality and risk of cardiac events in relation to FEV1/VC in a population-based sample of men examined at age 55 years. We stratified subjects as having FEV1/VC ≥ 0.7 (N), <0.7 but > LLN (FR+) and <0.7 and <LLN (FR+LLN+). Hazard ratio for death was 1, 1.33 (0.94-1.9) and 1.71 (1.3-2.2), respectively, when adjusted for smoking and a number of cardiovascular risk factors. In contrast, there was no increase in the corrected hazard ratio for cardiac events. FEV1 progressively declined and LCI increased from N to FR+ and FR+LLN+. Subjects with FEV1/VC ratio below 0.7 but above the lower limit of normal form an intermediate group with respect to lung function impairment and mortality rates. Careful evaluation of patient history and extended lung function testing may be warranted in subjects with FEV1/VC < 0.7 but above the lower limit of normal. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Respiratory Medicine
publisher
Elsevier
external identifiers
  • PMID:23845882
  • WOS:000330271600023
  • Scopus:84883053802
ISSN
1532-3064
DOI
10.1016/j.rmed.2013.06.016
language
English
LU publication?
yes
id
5cebc371-997a-46c0-9547-31bea5cde7a4 (old id 3955950)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23845882?dopt=Abstract
date added to LUP
2013-08-02 12:06:40
date last changed
2016-11-27 04:28:08
@misc{5cebc371-997a-46c0-9547-31bea5cde7a4,
  abstract     = {There is no consensus on the appropriate cut-off level for the ratio between forced expiratory volume and vital capacity (FEV1/VC) for the diagnosis of chronic obstructive pulmonary disease (COPD). Application of a fixed ratio of 0.7 carries the risk of false positive diagnoses in elderly subjects and false negative diagnoses in younger subjects. The use of the lower limit of normal (LLN) of an individually predicted value should eliminate this problem. There is insufficient information about the outcome of elderly subjects with an FEV1/VC &lt; 0.7 but above the LLN. We report lung function (spirometry and lung clearance index, LCI), mortality and risk of cardiac events in relation to FEV1/VC in a population-based sample of men examined at age 55 years. We stratified subjects as having FEV1/VC ≥ 0.7 (N), &lt;0.7 but &gt; LLN (FR+) and &lt;0.7 and &lt;LLN (FR+LLN+). Hazard ratio for death was 1, 1.33 (0.94-1.9) and 1.71 (1.3-2.2), respectively, when adjusted for smoking and a number of cardiovascular risk factors. In contrast, there was no increase in the corrected hazard ratio for cardiac events. FEV1 progressively declined and LCI increased from N to FR+ and FR+LLN+. Subjects with FEV1/VC ratio below 0.7 but above the lower limit of normal form an intermediate group with respect to lung function impairment and mortality rates. Careful evaluation of patient history and extended lung function testing may be warranted in subjects with FEV1/VC &lt; 0.7 but above the lower limit of normal.},
  author       = {Wollmer, Per and Engström, Gunnar},
  issn         = {1532-3064},
  language     = {eng},
  month        = {07},
  publisher    = {ARRAY(0x59695b8)},
  series       = {Respiratory Medicine},
  title        = {Fixed ratio or lower limit of normal as cut-off value for FEV1/VC: An outcome study.},
  url          = {http://dx.doi.org/10.1016/j.rmed.2013.06.016},
  year         = {2013},
}