Journal article
Preserved Ratio Impaired Spirometry in a Spirometry Database
Respiratory care, Vol.66(1), pp.58-65
01/01/2021
DOI: 10.4187/respcare.07712
PMCID: PMC7856524
PMID: 32873751
Abstract
BACKGROUND: Spirometry results can yield a diagnosis of normal air flow, air flow obstruction, or preserved ratio impaired spirometry (PRISm), defined as a reduced FEV(1)or FVC in the setting of preserved FEV1/FVC. Previous studies have estimated the prevalence of PRISm to be 7-12%. Our objective was to examine the prevalence of PRISm in a spirometry database and to identify factors associated with PRISm. METHODS: We performed a retrospective analysis of 21,870 spirometries; 1,616 were excluded because of missing data or extremes of age, height, or weight. We calculated the prevalence of PRISm in prebronchodilator and postbronchodilator pulmonary function tests. Subsequently, we calculated the prevalence of I'RISm by various age, race, body mass index, and diagnosis categories, as well as by gender and smokers versus nonsmokers. Finally, in the subset of the cohort with FEV1 < lower limit of normal, we performed a multivariable logistic regression analysis to identify factors associated with PRISm. RESULTS: We identified 18,059 prebronchodilator spirometries, and 22.3% of these yielded a PRISm diagnosis. This prevalence remained stable in postbronchodilator spirometries (17.7%), after excluding earlier pulmonary function tests for subjects with multiple pulmonary function tests (20.7% in prebronchodilator and 24.3% in postbronchodilator), and when we limited the analysis to prebronchodilator spirometries that met American Thoracic Society criteria (20.6%). The PRISm prevalence was higher in subjects 45-60 y old (24.4%) and in males (23.7%) versus females (17.9%). The prevalence rose with body mass index and was higher for those with a referral diagnosis of restrictive lung disease (50%). PRISm prevalence was similar between races and smokers versus nonsmokers. In a multivariable analysis, higher % of predicted FEV1(odds ratio 1.51, 95% CI 1.42-1.60), body mass index (odds ratio 1.52, 95% CI 139-1.68), and restrictive lung disease (odds ratio 432, 95% CI 2.54-757) were associated with a diagnosis of PRISm. Smoking was inversely associated (odds ratio 0.55, 95% CI 0.46-0.65) with PRISm. CONCLUSIONS: In a spirometry database at an academic medical center, the PRISm prevalence was 17-24%, which is higher than previously reported.
Details
- Title: Subtitle
- Preserved Ratio Impaired Spirometry in a Spirometry Database
- Creators
- Andrei Schwartz - Roy J. and Lucille A. Carver College of MedicineNicholas Arnold - Roy J. and Lucille A. Carver College of MedicineBecky Skinner - University of Iowa Hospitals and ClinicsJacob Simmering - University of Iowa Hospitals and ClinicsMichael Eberlein - University of IowaAlejandro P. Comellas - University of Iowa Hospitals and ClinicsSpyridon Fortis - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Respiratory care, Vol.66(1), pp.58-65
- DOI
- 10.4187/respcare.07712
- PMID
- 32873751
- PMCID
- PMC7856524
- NLM abbreviation
- Respir Care
- ISSN
- 0020-1324
- eISSN
- 1943-3654
- Publisher
- Daedalus Enterprises Inc
- Number of pages
- 8
- Grant note
- American Thoracic Society 14380 / Department of Veterans Affairs; US Department of Veterans Affairs CIN 13-412 / Comprehensive Access and Delivery Research and Evaluation Center Fisher Paykel
- Language
- English
- Date published
- 01/01/2021
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Health Management and Policy; ICTS; Pharmacy Practice and Science; Internal Medicine
- Record Identifier
- 9984359838602771
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