Perseverant, non-indicated treatment of obese patients for obstructive lung disease

Spyridon Fortis; Joseph Kittah; Manuel De Aguirre; Maria Plataki; Armand Wolff; Yaw Amoateng-Adjepong; Constantine A Manthous

doi:10.1186/1471-2466-13-68

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Perseverant, non-indicated treatment of obese patients for obstructive lung disease

Journal article

Open access

Peer reviewed

Perseverant, non-indicated treatment of obese patients for obstructive lung disease

Spyridon Fortis, Joseph Kittah, Manuel De Aguirre, Maria Plataki, Armand Wolff, Yaw Amoateng-Adjepong and Constantine A Manthous

BMC pulmonary medicine, Vol.13(1), pp.68-68

11/22/2013

DOI: 10.1186/1471-2466-13-68

PMCID: PMC4222837

PMID: 24266961

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Abstract

Background: Bronchodilators are a mainstay of treatment for patients with airflow obstruction. We hypothesized that patients with obesity and no objective documentation of airflow obstruction are inappropriately treated with bronchodilators. Methods: Spirometric results and medical records of all patients with body mass index >30 kg/m2 who were referred for testing between March 2010 and August 2011 were analyzed. Results: 155 patients with mean age of 52.6 ± (SE)1.1 y and BMI of 38.7 ± 0.7 kg/m2 were studied. Spirometry showed normal respiratory mechanics in 62 (40%), irreversible airflow obstruction in 36 (23.2%), flows suggestive of restriction in 35 (22.6%), reversible obstruction, suggestive of asthma in 11 (7.1%), and mixed pattern (obstructive and restrictive) in 6 (3.9%). Prior to testing, 45.2% (28 of 62) of patients with normal spirometry were being treated with medications for obstructive lung diseases and 33.9% (21 of 62) continued them despite absence of airflow obstruction on spirometry. 60% (21 of 35) of patients with a restrictive pattern in their spirometry received treatment for obstruction prior to spirometry and 51.4% (18 of 35) continued bronchodilator therapy after spirometric testing. There was no independent association of non-indicated treatment with spirometric results, age, BMI, co-morbidities or smoking history. All patients with airflow obstruction on testing who were receiving bronchodilators before spirometry continued to receive them after testing. Conclusion: A substantial proportion of patients with obesity referred for pulmonary function testing did not have obstructive lung disease, but were treated nonetheless, before and after spirometry demonstrating absence of airway obstruction.

Obesity

Asthma

Spirometry

Restriction

Pulmonary function

Airflow obstruction

Details

Title: Subtitle: Perseverant, non-indicated treatment of obese patients for obstructive lung disease
Creators: Spyridon Fortis - Department of Medicine, Bridgeport Hospital and Yale School of Medicine, New Britain, CT 06050, USA
Joseph Kittah - Department of Medicine, Bridgeport Hospital and Yale School of Medicine, New Britain, CT 06050, USA
Manuel De Aguirre - Department of Medicine, Bridgeport Hospital and Yale School of Medicine, New Britain, CT 06050, USA
Maria Plataki - Department of Medicine, Bridgeport Hospital and Yale School of Medicine, New Britain, CT 06050, USA
Armand Wolff - Department of Medicine, Bridgeport Hospital and Yale School of Medicine, New Britain, CT 06050, USA
Yaw Amoateng-Adjepong - Department of Medicine, Bridgeport Hospital and Yale School of Medicine, New Britain, CT 06050, USA
Constantine A Manthous - Department of Medicine, Bridgeport Hospital and Yale School of Medicine, New Britain, CT 06050, USA
Resource Type: Journal article
Publication Details: BMC pulmonary medicine, Vol.13(1), pp.68-68
DOI: 10.1186/1471-2466-13-68
PMID: 24266961
PMCID: PMC4222837
NLM abbreviation: BMC Pulm Med
ISSN: 1471-2466
eISSN: 1471-2466
Publisher: BioMed Central
Language: English
Date published: 11/22/2013
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
Record Identifier: 9984094523802771

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