Fixed ratio or lower limit of normal as cut-off value for FEV1/VC: An outcome study.
(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)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/3955950
- author
- Wollmer, Per LU and Engström, Gunnar LU
- organization
- publishing date
- 2013-07-08
- 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
- 2016-04-04 09:23:30
- date last changed
- 2023-09-19 23:04:16
@article{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 < 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.}}, author = {{Wollmer, Per and Engström, Gunnar}}, issn = {{1532-3064}}, language = {{eng}}, month = {{07}}, publisher = {{Elsevier}}, 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}}, doi = {{10.1016/j.rmed.2013.06.016}}, year = {{2013}}, }