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PubMed1981

[Use of routinely performed spirometry in the general medical examination (author's transl)].

The value of routine spirometry was investigated in 631 unselected out-patients. The spirogram was abnormal in 17%, the ECG in 15% and the chest X-ray in 13% of patients. Pathological spirograms correlated mainly with mild or moderate obstructive ventilatory disturbances (80%) which were associated with clinical findings in only 74%. In the ECG, disturbances of repolarisation were more common (71%) than those of stimulation and conduction (29%) and were associated with clinical findings in 65%. In 91% of patients with pathological chest radiograms other investigations had indicated the necessity for an X-ray. Thus spirometry is, in addition to ECG and chest X-ray, a useful routine method. As disorders of the lung function are not always predictable by smoking habits, spirometry offers the possibility for early detection of symptom-free disease of the lung and respiratory tract.

Electrocardiography↗

PubMed1993

Spirometry--acceptability and reproducibility in spinal cord injured subjects.

The American Thoracic Society (ATS) has formulated guidelines for spirometry. We hypothesized that individuals with SCI (SCI), as a result of weak respiratory muscles, would exhibit poor test acceptability and reproducibility. Seventy-eight SCI subjects (39 with complete SCI) answered a respiratory questionnaire and performed spirometry. Of those with complete SCI, the proportion of subjects which met ATS criteria decreased with higher levels of injury. Poor test performance was not associated with age, respiratory symptoms or muscle fatigue. The most common reason for failing to meet ATS criteria for acceptability was excessive back extrapolated volumes (EBEV). Individuals with efforts that were acceptable except for EBEV and/or for exhalation of less than six seconds had values for forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) that were reproducible. If ATS criteria for acceptable spirometry were used in studying subjects with SCI, individuals producing otherwise reproducible values for FVC and FEV1 would be excluded. We found reproducibility similar to what has been reported in other cohorts and conclude that longitudinal study of respiratory function in SCI is feasible.

Adult↗

PubMed2004

Prevalence and risk factors for chronic obstructive pulmonary disease according to symptoms and spirometry.

The burden of COPD is quite high and its prevalence is increasing. Few data are available from Latin America. There is no consensus on what criteria should be the gold standard for the definition of this disease. A population-based study was carried out in a southern Brazilian city, including adults aged 40-69 years. The aim was to measure the prevalence of COPD according to several criteria. From the 1,046 subjects chosen from a multiple-stage sampling protocol, a sub-sample of 234 subjects was systematically selected to undergo spirometry. Percentages of COPD according to different criteria were: chronic bronchitis by questionnaire (7.8%); GOLD stage 0 (7.3%); fixed ratio (15.2%); GOLD stage II (9.9%); ERS (27.7%). The relationship among the three lung functional measurements showed that around 70% of all subjects had negative results with all three criteria, and around 10% were positive according to all three. Utilization of symptom-based or spirometry definitions of COPD provide different prevalence estimates. Use of different spirometric criteria also resulted in different percentages of COPD. According to spirometry, COPD was higher among men, elderly, those with low education and ex-smokers. On the other hand, current smokers were more likely to present symptoms of chronic bronchitis. The fixed ratio criterion is recommended when population-specific reference curves are not available, while the GOLD definition is recommended to evaluate severity of COPD.

Adult↗

PubMed1991

Infection risks associated with spirometry.

OBJECTIVES: Spirometry is a widely used pulmonary function test that allows measurement of forced vital capacity and time-related measures of dynamic pulmonary function. This study was designed to identify the risk of cross-transmission associated with two commonly used dryrolling seal spirometers. DESIGN: Using a prospective study design, we examined whether microbial contamination of spirometers occurred following use by patients with a heavily colonized or infected respiratory tract. Prior to spirometry evaluation, a patient's sputum culture and equipment samples (i.e., mouthpiece, proximal tubing, piston surface) were obtained. After patient evaluation, a sterile 2 L ventilation bag and sterile tubing were used to simulate the risk of infection of subsequent patients. Simulation 1 was performed immediately after patient testing and Simulation 2, representing a second patient was conducted approximately 18 hours later. SETTING: This study was conducted at the University of North Carolina Hospitals, a large university teaching facility. PATIENTS: Fourteen patients with underlying pulmonary disease were studied. RESULTS: Our study revealed that the mouthpieces became contaminated with the patients' oral flora and with the associated respiratory pathogen. Fourteen percent of the associated tubing after patient testing contained the respiratory pathogen. All other equipment samples (e.g., interior surfaces of the machine, Simulation 1, Simulation 2 samples) were negative for the respiratory pathogen. CONCLUSIONS: These data suggest that mouthpieces and spirometry tubing may become contaminated with microorganisms and should not be shared between patients. Since there is little or no bacterial contamination of the surfaces inside the spirometers and cross transmission is unlikely, it is unnecessary to routinely clean the interior surfaces of the spirometers.

Cross Infection↗

PubMed2004

Effect of obesity and thoracic epidural analgesia on perioperative spirometry.

BACKGROUND: Lung volumes in obese patients are reduced significantly in the postoperative period. As the effect of different analgesic regimes on perioperative spirometric tests in obese patients has not yet been studied, we investigated the effect of thoracic epidural analgesia and conventional opioid-based analgesia on perioperative lung volumes measured by spirometry. METHODS: Eighty-four patients having midline laparotomy for gynaecological procedures successfully completed the study. Premedication, anaesthesia and analgesia were standardized. The patients were given a free choice between epidural analgesia (EDA) (n=42) or opioids (n=42) for postoperative analgesia. We performed spirometry to measure vital capacity (VC), forced vital capacity, peak expiratory flow, mid-expiratory flow and forced expiratory volume in 1 s at preoperative assessment, 30-60 min after premedication and 20 min, 1 h, 3 h and 6 h after extubation. RESULTS: Baseline values were all within the normal range. All perioperative spirometric values decreased significantly with increasing body mass index (BMI). The greatest reduction in VC occurred directly after extubation, but was less in the EDA group than in the opioid group: mean of -23(sd 8)% versus -30(12)% (P<0.001). In obese patients (BMI>30) the difference in VC was significantly more pronounced than in patients of normal weight (BMI<25): -45(10)% versus -33(4)% (P<0.001). Recovery of spirometric values was significantly quicker in patients receiving EDA, particularly in obese patients. CONCLUSION: We conclude that EDA should be considered in obese patients undergoing midline laparotomy to improve postoperative spirometry.

Adult↗

PubMed1987

Spirometry variability criteria--association with respiratory morbidity and mortality in a cohort of coal miners.

To clarify the association between spirometry variability and respiratory morbidity and mortality, the authors analyzed data for miners examined in the first round of the National Coal Study, 1969-1971, and they compared groups of miners who failed with those who met each of two spirometry variability criteria: a 5% criterion recommended by the American Thoracic Society, and a 200 ml criterion used in prior research studies. Compared with miners who met the 5% criterion (the best two forced vital capacities must be within 5% or 100 ml of one another), the group that failed had a lower mean for forced expiratory volume in one second (FEV1), and odds ratios for cough, phlegm, wheeze, shortness of breath, and death of 1.75, 1.67, 1.76, 2.71, and 1.30, respectively. The findings for the 200 ml criterion (the best two FEV1s must be within 200 ml of one another) were somewhat different. The group that failed versus the group that met this criterion had a higher mean for FEV1, and odds ratios for cough, phlegm, wheeze, shortness of breath, and death of 1.13, 1.07, 1.15, 1.43, and 0.94, respectively. Although the findings differ for the two criteria, the findings demonstrate that increased spirometry variability is associated with poorer health.

Adult↗

PubMed1994

Are incentive spirometry, intermittent positive pressure breathing, and deep breathing exercises effective in the prevention of postoperative pulmonary complications after upper abdominal surgery? A systematic overview and meta-analysis.

BACKGROUND AND PURPOSE: The purpose of this meta-analysis was to quantitatively assess the conflicting body of literature concerning the efficacy of incentive spirometry (IS), intermittent positive pressure breathing (IPPB), and deep breathing exercises (DBEX) in the prevention of postoperative pulmonary complications in patients undergoing upper abdominal surgery. METHODS: Computerized searches of MEDLINE and the Cumulative Index to Nursing and Allied Health databases were performed for the years 1966 through 1992. Citations were selected based on the following relevance criteria: (1) patients undergoing any type of upper abdominal surgery; (2) any combination of IS, IPPB, and DBEX; (3) an outcome of pulmonary complications; and (4) randomized trials. Review of 116 citations yielded 55 potential trials and 10 review articles. Of these, 14 citations were included in the overview based on relevance criteria requirements. Study validity was assessed by two independent observers, and data were extracted. RESULTS: The common odds ratio (COR) for the occurrence of pulmonary complications for IS versus no physical therapy was 0.44 in favor of IS. The COR for DBEX versus no physical therapy was 0.43 in favor of DBEX. Both findings were statistically significant. The CORs for IS versus IPPB, IS versus DBEX, and IPPB versus DBEX were 0.76 (95% confidence interval [CI] = 0.39-1.4), 0.91 (95% CI = 0.57-1.4), and 0.94 (95% CI = 0.28-3.17), respectively. None of these comparisons reached statistical significance. CONCLUSION AND DISCUSSION: Incentive spirometry and DBEX appear to be more effective than no physical therapy intervention in the prevention of postoperative pulmonary complications. There is no evidence to support a significant difference between any of the three modalities. [Thomas JA, McIntosh JM. Are incentive spirometry, intermittent positive pressure breathing, and deep breathing exercises effective in the prevention of postoperative pulmonary complications after upper abdominal surgery? a systematic overview and meta-analysis.

Abdomen↗

PubMed1997

The effectiveness of incentive spirometry with physical therapy for high-risk patients after coronary artery bypass surgery.

BACKGROUND AND PURPOSE: The purpose of this study was to determine whether the addition of incentive spirometry (IS) to postoperative pulmonary physical therapy is more effective than physical therapy alone in reducing postoperative pulmonary complications in high-risk patients after coronary artery bypass grafting (CABG). Patients were given the spirometer and instructed in its use, as often occurs in clinical settings. SUBJECTS: Patients with chronic airflow limitation following CABG (N = 185) participated. METHODS: Subjects were randomly assigned to receive either postoperative pulmonary physical therapy (breathing exercises, secretion removal, mobility) or physical therapy combined with IS. RESULTS: No difference was found between the two groups in atelectasis, spirometry, oxygen saturation, pulmonary infection, or hospital stay. CONCLUSION AND DISCUSSION: Incentive spirometry combined with physical therapy is no more effective than postoperative physical therapy alone in reducing atelectasis for this population. Use of the spirometer, however, was not monitored, and although the study mimicked practice as it often occurs, the effectiveness of the spirometer cannot be fully evaluated.

Adult↗

PubMed1982

An evaluation of incentive spirometry in the management of pulmonary complications after cardiac surgery in a pediatric population.

Changes in pulmonary function and the development of atelectasis in the postoperative period have been well documented in the adult population. The use of incentive spirometry has been shown to be effective in the prevention of these postoperative complications. At the Hospital of Sick Children, we studied 17 children (8 control and 9 study) to determine if the same trends occurred. Baseline and follow-up roentgenograms and pulmonary function tests (PFTs) were documented for both groups. In addition, the study group followed the protocol for incentive spirometry. There was significantly less atelectasis in the study group (33%) than in the control group (88%). There was a significant loss of pulmonary function postoperatively in both groups. However, there were no statistically significant differences between the groups either in the degree of pulmonary function loss postoperatively or in the recovery baseline pulmonary function to discharge. We conclude that incentive spirometry is as effective in reducing the incidence of atelectasis in children undergoing cardiac surgery as in adults.

Adolescent↗

PubMed2000

ACOEM position statement. Spirometry in the occupational setting. American College of Occupational and Environmental Medicine.

This position statement reviews several aspects of spirometric testing in the workplace, where spirometry is employed in the primary, secondary, and tertiary prevention of occupational lung disease. Primary prevention includes pre-placement and fitness-for-duty examinations as well as research and monitoring of health status in groups of exposed workers; secondary prevention includes periodic medical screening of individual workers for early effects of exposure to known occupational hazards; and tertiary prevention includes clinical evaluation and impairment/disability assessment. For all of these purposes, valid spirometry measurements are critical, requiring: documented spirometer accuracy and precision, a rigorous and standardized testing technique, standardized measurement of pulmonary function values from the spirogram, adequate initial and refresher training of spirometry technicians, and, ideally, quality assessment of samples of spirograms. Interpretation of spirometric results usually includes comparison with predicted values and should also evaluate changes in lung function over time. Response to inhaled bronchodilators and changes in relation to workplace exposure may also be assessed. Each of these interpretations should begin with an assessment of test quality and, based on the most recent ATS recommendations, should rely on a few reproducible indices of pulmonary function (FEV1, FVC, and FEV1/FVC.) The use of FEF rates (e.g., the FEF25-75%) in interpreting results for individuals is strongly discouraged except when confirming borderline airways obstruction. Finally, the use of serial PEF measurements is emerging as a method for confirming associations between reduced or variable pulmonary function and workplace exposures in the diagnosis of occupational asthma. Throughout this position statement, ACOEM makes detailed recommendations to ensure that each of these areas of test performance and interpretation follow current recommendations/standards in the pulmonary and regulatory fields. Submitted by the Occupational and Environmental Lung Disorder Committee on November 16,1999. Approved by the ACOEM Board of Directors on January 4,2000.

Female↗

PubMed2005

A comparison of plethysmography, spirometry and oscillometry for assessing the pulmonary effects of inhaled ipratropium bromide in healthy subjects and patients with asthma.

AIMS: We have compared the ability of plethysmography (sGaw), impulse oscillometry (IOS) and spirometry (FEV(1), MMEF) to detect bronchodilation in response to an anticholinergic. METHODS: IOS (R5, R20, X5, RF), sGaw and spirometry were measured in 12 healthy subjects and 12 asthmatics. Variability was assessed by performing two measurements, 30 min apart and the effect of increasing the number of readings for each sGaw measurement was also studied. Ipratropium bromide (IB) 10, 20, 100 and 200 microg was administered and the sensitivity of the methods compared by determining the lowest dose that caused changes greater than variability. RESULTS: In healthy subjects significant changes (P < or = 0.05) occurred at 10 microg for FEV(1) (mean [95% CI]; 1.3%[0.3-2.3]), R5 (mean [95% CI]; -7.9%, [-13.2-2.6]) and R20 (mean [95% CI], -6.4%, [-11.4-1.4]). No significant change was detected when the mean of 3 sGaw readings was used, but with 10 readings significant change was observed at 20 microg; (mean increase [95% CI] 15.2%[8.3-22.1]). In asthmatics significant changes (P < or = 0.05) occurred with IB 10 microg for sGaw (mean [95% CI] 25.6%[11.1-40.1]), R5 (mean [95% CI]-11.3%, [-15.5-7.2]), RF (mean [95% CI] 11.7%[6.1-16.3]), FEV(1) (mean [95% CI] 5.1%[2.6-7.7]) and MMEF (mean [95% CI] 12.3%[2.3-22.2]). CONCLUSION: IOS and spirometry are more sensitive than sGaw in healthy subjects, but the sensitivity of sGaw improved when the number of readings was increased. The most sensitive method for assessing bronchodilation in asthmatics was sGaw.

Adult↗

PubMed2005

The effect of Ramadan fasting on spirometry in healthy subjects.

OBJECTIVES: Lung function tests are an important investigative tool in diagnosing respiratory diseases, judging their severity and assessing prognosis. The primary aim of the present study was to assess whether Ramadan fasting affected normal lung function values. METHODOLOGY: Forty-six non-smoking healthy males, with a mean age of 24.2 years (SD 6.4 years) were investigated. Spirometry was performed according to the recommendations of the American Thoracic Society. Days between the 15th and 25th of three Islamic months (pre-Ramadan, Ramadan and post-Ramadan) were selected for spirometry. On all three occasions, FVC, FEV(1), FEV(1)/FVC%, maximum voluntary ventilation (MVV(indirect)), PEF, FEF(25--75%) and body mass were measured. Pre- and post-Ramadan readings were compared with the readings during Ramadan fasting. The results were analysed by repeated measures analysis of variance. RESULTS: No significant change was seen in lung function during Ramadan as compared to the pre-Ramadan period. FVC was decreased significantly in the post-Ramadan period compared to Ramadan and this period was associated with a significant increase in body mass. CONCLUSION: Relative to pre-Ramadan baseline values, there was no change in spirometry during Ramadan fasting in these subjects.

Adolescent↗

PubMedDate not supplied

The costs of implementing the 1999 Canadian Asthma Consensus Guidelines recommendation of asthma education and spirometry for the family physician.

BACKGROUND: National and international asthma guidelines recommend that patients with asthma be provided with asthma education and spirometry as a component of enhanced asthma care. The cost of implementing these interventions in family physician practices is not known. OBJECTIVE: The objective of the present study was to determine the cost of providing recommended asthma care to adult patients in the family practice setting. METHODS: The present study was conducted using three scenarios of care in family practice. Small, medium and large asthmatic patient populations were used. The incremental costs of implementing enhanced asthma care based on the Canadian Asthma Consensus Guidelines, including the provision of spirometry and asthma education in both group and individual sessions, and the resources required for these interventions were calculated for each scenario. RESULTS: For a physician with 50 asthmatic patients, the cost of providing enhanced asthma care with spirometry and group education sessions was approximately 78 dollars per patient in the first year of implementation. For individual sessions, the cost increased to 100 dollars per patient for the first year. If the physician had 100 asthmatic patients, the per patient cost would decrease; however, the overall cost of the program would be 7,000 dollars. CONCLUSIONS: The costs of providing enhanced asthma care are significant. In most cases, physicians are inadequately reimbursed (or not reimbursed) for these interventions. In light of the evidence of the effectiveness of these interventions, health insurance plans should consider adding these services to fee schedules.

Asthma↗

PubMedDate not supplied

Lung function measured by impulse oscillometry and spirometry following eucapnic voluntary hyperventilation.

BACKGROUND: The efficacy of impulse oscillometry (IOS) to measure airway calibre change is not fully established. OBJECTIVES: To evaluate lung function change after eucapnic voluntary hyperventilation (EVH), and to compare IOS indices with spirometric maximal expiratory flow measurements. METHODS: Twenty subjects (10 airway hyperresponsive [AHR+] and 10 normal [AHR--]) underwent IOS and spirometry before and for 15 min after 6 min EVH (inhaling 5% CO2, 21% O2, balance N2) at a target ventilation of 30 times the baseline value of the forced expiratory volume in 1 s (FEV1) at 20 degrees C. AHR+ was defined by a fall in FEV1 of 10% or greater from baseline after a provoking challenge. Airway resistance at 5 Hz (R5), reactance at 5 Hz, resonant frequency (Fres), area of reactance integrated from 5 Hz to Fres (AX), and FEV1 were determined. RESULTS: No baseline spirometry values correlated with falls in FEV1. Baseline R5 and AX values correlated with peak falls in FEV1 (r= -0.51 and -0.46, respectively; P< 0.05). AHR+ subjects demonstrated greater per cent peak falls in FEV1 than did AHR- subjects following EVH (30.6 +/- 14.0% versus 7.5 +/- 2.6%, respectively; P<0.05). Changes in R5, Fres, reactance and AX were greater for AHR+ subjects than for AHR- subjects and correlated with a fall in FEV1 (r= -0.74, -0.70, 0.69 and -0.73, respectively; P<0.05). At a designated specificity of 80%, the per cent change in R5 (50% or greater) and post-EVH AX (12 cm H2O/L or greater) yielded sensitivities to a 10% fall in FEV1 of 90%. CONCLUSION: IOS is an acceptable measure to determine AHR and can supplement spirometry in lung function evaluation.

Adult↗

PubMedDate not supplied

Spirometry reference values for women and men aged 65-85 living in southern Europe: the effect of health outcomes.

BACKGROUND: Spirometry is more and more frequently used for the diagnosis of respiratory diseases in the elderly people. Unfortunately, reliable predictive values for the spirometric variables in the elderly are lacking. OBJECTIVES: Data obtained from 429 subjects participating in the multicenter Italian study SARA on respiratory health in the elderly were analyzed in order to derive reference values for spirometry in the age range of 65-85 years. The second aim of this study was to assess the influence of variables describing many dimensions of the health status on the prediction of spirometric variables in that age range. METHODS: Subjects were recruited as consecutive outpatients referred during the study period to 24 geriatric or respiratory institutions distributed throughout Italy. Spirometries were performed using the same equipment by specifically trained and certified personnel supervised by a real-time quality control program. In addition to the standard anthropometric variables, covariates describing the affective, mental, and general health conditions were investigated through standardized questionnaires, to improve the modeling of spirometric outcomes. RESULTS: Reliable predictive values for forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were produced (coefficient of determination, for FVC: R2 = 0.64; for FEV1: R2 = 0.54). The effect of general health conditions on spirometric outcomes accounted for the most part of the between-gender difference in the ageing-dependent decrease in lung function. CONCLUSIONS: We suggest that a multidimensional approach to health problems should be used for a better interpretation of spirometric results in the elderly.

Aged↗

PubMed1995

Spirometry in the Lung Health Study: II. Determinants of short-term intraindividual variability.

The Lung Health Study (LHS) is a randomized clinical trial designed to determine whether a smoking intervention program and use of an inhaled bronchodilator (BD) can reduce the rate of decline of FEV1 in cigarette smokers with airflow limitation. During recruitment, spirometry was performed at second and third screening visits, a mean of 21 d apart. A total of 5,887 smokers, 35 to 60 yr of age and of whom 63% were men, met the study eligibility requirements. Smokers taking physician-prescribed BDs or with an FEV1 < 50% or > 90% predicted were excluded, as were those whose FEV1/FVC ratio was greater than 70%. Two inhalations of isoproterenol were given to determine BD response during the second visit. A serial dilution methacholine challenge test was done during the third visit to determine nonspecific airway reactivity. Ninety-five percent of the differences between FEV1 measured at the two visits were within 240 ml for women and within 320 ml for men (coefficients of repeatability). The best independent predictors of the mean short-term (between visit) intraindividual FEV1 variability were factors indicating intrinsic airway reactivity of the participants: bronchodilator response, methacholine reactivity, and the presence of wheezing; as well as factors influenced by the quality of spirometry testing: the difference between the highest and second highest FEV1s and peak flows during baseline spirometry, and the time to reach peak flow (PEFT).

Adult↗

PubMed1997

Spirometry values in stable lung transplant recipients.

To clarify the usefulness of spirometry to assess the function of the lung allograft post-transplant, we retrospectively reviewed 351 sequential spirometry measurements performed by 65 healthy recipients after the 80th postoperative day when the clinical evaluation and fiberoptic bronchoscopy with transbronchial biopsies and bronchoalveolar lavage excluded significant rejection or infection in the allograft. The mean coefficients of variation (CV) and significant values for change (SC) for the FVC, FEV1, and FEF25-75% were calculated according to the type of transplant procedure (heart-lung and double-lung [HL-DL] versus single-lung [SL]), and to the time after transplant when the spirometry measurements were obtained < or = 1 yr versus > 1 yr). The SC for the FVC decreased with time after transplantation for both HL-DL (< or = 1 yr: 17% versus > 1 yr: 7%) and SL recipients (< or = 1 yr: 13% versus > 1 yr: 8%). The higher degree of variability within the first year was primarily due to increasing values especially in the HL-DL recipients. The SC for the FEV1 also decreased over time for HL-DL recipients (< or = 1 yr: 18% versus > 1 yr: 9%) but was similar for SL recipients at both intervals (13%). Our results suggest that decreases of > or = 11% in FVC or 12% in FEV1 in HL-DL recipients and > or = 12% in FVC or 13% in FEV1 for SL recipients indicate a significant decrease in allograft function that may be due to infection or rejection.

Forced Expiratory Volume↗

PubMed2000

Quality control of spirometry in the elderly. The SA.R.A. study. SAlute Respiration nell'Anziano = Respiratory Health in the Elderly.

We evaluated the outcome of the spirometry quality control program of the SA.R.A. multicenter project, the aim of which is the multidimensional assessment of asthma and COPD in the elderly (>/= 65 yr). The factors determining this quality were also evaluated. The program was based on standardized procedures (ATS recommendations), performed by specifically trained and certified personnel; a fully-computerized spirometer with customized software was used for spirometry. A reference center made monthly controls. Overall, 638 cases and 984 controls were examined. Spirometric measurements were obtained in 607 cases and 912 controls; 508 and 747 tests with at least three acceptable curves were obtained in cases and in controls, respectively (NS). The percentage of reproducible tests ranged between 95.8% for FEV(1) in controls and 87.6% for FVC in cases. The average reproducibility for FEV(1) was 61.6 ml in cases and 58.3 ml in controls (NS). Cognitive impairment, shorter 6-min walk distance, and lower educational level were found to be independent risk factors for a poorer acceptability rate (logistic regression analysis). Male sex and age were risk factors for a poorer reproducibility of FEV(1). Reproducibility tended to improve with time (p < 0.001). Although spirometry becomes increasingly difficult in aging patients, a rigorous quality control program can ensure that reliable data are obtained in the majority of patients.

Age Factors↗