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Prevalence of abnormal spirometry in individuals with a smoking history and no known obstructive lung disease

2023; Elsevier BV; Volume: 208; Linguagem: Inglês

10.1016/j.rmed.2023.107126

1532-3064

Thuonghien V. Tran, Gregory L. Kinney, Alejandro P. Comellas, Karin F. Hoth, Arianne K. Baldomero, A. James Mamary, Jeffrey L. Curtis, Nicola A. Hanania, Richard Casaburi, Kendra A. Young, V. Kim, Barry J. Make, Emily S. Wan, Alejandro A. Díaz, John E. Hokanson, James D. Crapo, Edwin K. Silverman, Surya P. Bhatt, Elizabeth A. Regan, Spyridon Fortis, James D. Crapo, Edwin K. Silverman, Barry J. Make, Elizabeth A. Regan, Terri H. Beaty, Peter J. Castaldi, Michael H. Cho, Dawn L. DeMeo, Adel Boueiz, Marilyn G. Foreman, Auyon Ghosh, Lystra P. Hayden, Craig P. Hersh, Jacqueline B. Hetmanski, Brian D. Hobbs, John E. Hokanson, Wonji Kim, Nan M. Laird, Christoph Lange, Sharon M. Lutz, Merry‐Lynn McDonald, Dmitry Prokopenko, Matthew Moll, Jarrett D. Morrow, Dandi Qiao, Elizabeth A. Regan, Aabida Saferali, Phuwanat Sakornsakolpat, Edwin K. Silverman, Emily S. Wan, Jeong H. Yun, Juan Pablo Centeno, Jean‐Paul Charbonnier, Harvey O. Coxson, Craig J. Galbán, MeiLan K. Han, Eric A. Hoffman, Stephen M. Humphries, Francine L. Jacobson, Philip F. Judy, Ella A. Kazerooni, Alex Kluiber, David A. Lynch, Pietro Nardelli, John D. Newell, Aleena Notary, Andrea Oh, Elizabeth A. Regan, James C. Ross, Raúl San Jośe Estépar, Joyce Schroeder, Jered Sieren, Berend C. Stoel, Juerg Tschirren, Edwin J.R. van Beek, Bram van Ginneken, Eva M. van Rikxoort, Gonzalo Vegas Sanchez Ferrero, Lucas Veitel, George R. Washko, Carla G. Wilson, Robert L. Jensen, Douglas Curran‐Everett, Jim Crooks, Katherine Pratte, Matthew Strand, Carla G. Wilson, John E. Hokanson, Erin Austin, Gregory L. Kinney, Sharon M. Lutz, Kendra A. Young, Surya P. Bhatt, Jessica Bon, Alejandro A. Díaz, MeiLan K. Han, Barry J. Make, Susan Murray, Elizabeth A. Regan, Xavier Soler, Carla G. Wilson, Russell P. Bowler, Katerina Kechris, Farnoush Banaei‐Kashani, Jeffrey L. Curtis, Perry G. Pernicano, Nicola A. Hanania, Mustafa Atik, Aladin M. Boriek, Kalpatha Guntupalli, Elizabeth Guy, Amit Parulekar, Dawn L. DeMeo, Craig P. Hersh, Francine L. Jacobson, George R. Washko, R. Graham Barr, John Austin, Belinda D’Souza, Byron Thomashow, Neil MacIntyre, H. Page McAdams, Lacey Washington, Charlene McEvoy, Joseph Tashjian, Robert A. Wise, Robert Brown, Nadia N. Hansel, Karen M. Horton, Allison Lambert, Nirupama Putcha, Richard Casaburi, Alessandra Adami, Matthew J. Budoff, H. Keith Fischer, János Pórszász, Harry B. Rossiter, William W. Stringer, Amir Sharafkhaneh, Charlie Lan, Christine Wendt, Brian Bell, Ken M. Kunisaki, Eric L. Flenaugh, Hirut Gebrekristos, Mario Castro, Silanath Terpenning, Gloria Westney, Russell P. Bowler, David A. Lynch, Richard Rosiello, David Pace, Gerard J. Criner, David Ciccolella, Francis Cordova, Chandra Dass, Gilbert E. D’Alonzo, Parag Desai, Michael E. Jacobs, Steven Kelsen, V. Kim, A. James Mamary, Nathaniel Marchetti, Aditi Satti, Kartik Shenoy, Robert M. Steiner, Alex Swift, Irene Swift, Maria Elena Vega‐Sanchez, Mark Dransfield, William C. Bailey, Surya P. Bhatt, Anand Iyer, Hrudaya Nath, J. Michael Wells, Douglas Conrad, Xavier Soler, Andrew Yen, Alejandro P. Comellas, Karin F. Hoth, John D. Newell, Brad Thompson, MeiLan K. Han, Ella A. Kazerooni, Wassim W. Labaki, Craig J. Galbán, Dharshan Vummidi, Joanne Billings, Abbie Begnaud, Tadashi Allen, Frank C. Sciurba, Jessica Bon, Divay Chandra, Joel L. Weissfeld, Antonio Anzueto, Sylvia Adams, Diego Maselli-Caceres, Mario E. Ruiz, Harjinder Singh,

Pediatric health and respiratory diseases

Introduction Recent evidence suggests a high prevalence of undiagnosed chronic obstructive pulmonary disease (COPD). These individuals are at risk of exacerbations and delayed treatment. We analyzed an at-risk population for the prevalence of abnormal spirometry to provide clarity into who should undergo early spirometry. Methods We analyzed data from the COPDGene study. Participants with ≥10 pack-years of smoking were included. Individuals with self-reported or physician-diagnosed COPD, asthma, chronic bronchitis, emphysema and/or were on inhalers were excluded. Parsimonious multivariable logistic regression models identified factors associated with abnormal spirometry, defined as either airflow obstruction (AFO) or preserved ratio impaired spirometry. Variables were selected for the final model using a stepwise backward variable elimination process which minimized Akaike information criterion (AIC). Similarly, during the 5-year follow-up period, we assessed factors associated with incident diagnosis of COPD. Results Of 5055 individuals, 1064 (21%) had undiagnosed AFO. Age, pack-years, current smoking and a history of acute bronchitis were associated with AFO while body mass index, female sex, and Black race were inversely associated. Among 2800 participants with 5-year follow-up, 532 (19%) had an incident diagnosis of COPD. Associated risk factors included mMRC ≥2, chronic productive cough, respiratory exacerbations during the follow-up period, and abnormal spirometry. Age was inversely associated. Conclusions The prevalence of undiagnosed COPD is high in at-risk populations. We found multiple factors associated with undiagnosed COPD and incident diagnosis of COPD at follow up. These results can be used to identify those at risk for undiagnosed COPD to facilitate earlier diagnosis and treatment.