Agreement Between Fixed-Ratio and Lower Limit of Normal Spirometry Interpretation Protocols Decreases With Age Is There a Need for a New GOLD Standard?

作者:Mikulski Marek A*; Gerke Alicia K; Lourens Spencer; Czeczok Thomas; Sprince Nancy L; Laney Anthony S; Fuortes Laurence J
来源:Journal of Occupational and Environmental Medicine, 2013, 55(7): 802-808.
DOI:10.1097/JOM.0b013e31828b22cc

摘要

Objectives: To assess concordance between the fixed 70% ratio cutoff point with the fixed percent predicted values (Fixed-ratio) and the lower limit of normal (LLN) algorithms in interpreting spirometry results in an older population. Methods: Spirometries were interpreted using Third National Health and Nutrition Examination Survey reference equations for 2319 workers. Results: The Fixed-ratio algorithm characterized 34.5% (n = 801) results as abnormal, compared with 29.7% (n = 689) by the LLN. There were almost twice as many obstructive and mixed airways spirometries identified under the Fixed-ratio compared to LLN. Rates of restrictive pattern physiology were virtually the same under each algorithm. Overall agreement between the algorithms decreased with age from %26quot;almost perfect%26quot; for those younger than 60 years to %26quot;substantial%26quot; for those older than 80 years. Conclusions: This study found age-related discordance between two algorithms possibly related to the lack of reference equations and standards for individuals older than 80 years.

  • 出版日期2013-7