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Revista de investigación clínica

versión On-line ISSN 2564-8896versión impresa ISSN 0034-8376

Resumen

FERNANDEZ-PLATA, Rosario et al. Screening Tool for Restrictive and Obstructive Ventilatory Abnormalities in a Population-Based Survey. Rev. invest. clín. [online]. 2020, vol.72, n.6, pp.386-393.  Epub 09-Abr-2021. ISSN 2564-8896.  https://doi.org/10.24875/ric.20000235.

Background:

A 6 s spirometry with an inexpensive pocket spirometer efficiently selects individuals for a diagnostic-quality spirometry for airflow limitation, but could also be useful to identify individuals with a restrictive pattern.

Objectives:

We evaluated an inexpensive simplified spirometer (chronic obstructive pulmonary disease [COPD]-6) as a screening tool to identify spirometric abnormalities.

Methods:

A population-based survey in Mexico City, with 742 participants performing pre- and post-BD spirometry and a three-maneuver 6 s spirometry (pre-BD) with a COPD-6. We evaluated forced expiratory volume in 1 s (FEV1), FEV6, and FEV1/FEV6 from the COPD-6, crude and expressed as the percentage of predicted (%P), to discriminate post-bronchodilator airflow obstruction (FEV1/forced vital capacity [FVC] <5th percentile) or restriction (FVC or FEV1 <5th percentile with normal FEV1/FVC) through receiver operating characteristics and their area under the curve (AUC).

Results:

FEV1%P was the best predictor to identify pre- and post-BD ventilatory abnormalities (best cutoff point 87%P, AUC 92% for restrictive pattern, 89% for obstructive pattern, and 91% for any spirometric abnormality). Deriving to clinical spirometry only those with <87%P (26% of the sample) missed only 12% of spirometric abnormalities most of the latter mild.

Conclusions:

An FEV1 <87%P from a pre-BD 6 s spirometry correctly identified individuals with spirometric ventilatory defects, either obstructive or restrictive.

Palabras llave : Chronic Obstructive Pulmonary Disease; Restrictive pattern; Forced expiratory volume in 1 s; Screening; Case finding; Spirometry; COPD-6; Population-based survey.

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