Precision in Diagnosing and Classifying COPD: Comparison of Historical Height with Current Height and Arm Span to Predict FEV1
Khalid Ansari*, 1, Niall Keaney2, Monica Price1, Joan Munby1, Andrea Kay2, Ian Taylor2, Kathryn King1
Identifiers and Pagination:Year: 2012
First Page: 54
Last Page: 58
Publisher Id: TORMJ-6-54
Article History:Received Date: 6/4/2012
Revision Received Date: 25/4/2012
Acceptance Date: 26/4/2012
Electronic publication date: 24/7/2012
Collection year: 2012
open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
Measured reductions in lung function, as a result of COPD, use a measured current value and make comparisons to a determined ‘normal’ value arrived at using a regression equation based upon a patients height. Osteoporosis is a recognised co-morbidity in patients with chronic obstructive pulmonary disease (COPD) and may cause excessive height loss resulting in the ‘normal’ values and disease progression being under-estimated.
The aim of the study was to examine the height variation in a cohort of COPD patients and controls over a 7-8 years period and evaluate its impact on estimates of lung function and hence COPD progression.
In 1999-2002 we studied a cohort of primary care patients in Sunderland, UK with and without COPD and reexamined 104 (56 male) during 2007-2009. We calculated FEV1% predicted for actual and estimated height (armspan/1.03 and armspan/1.01 in males and females respectively).
In 1999-2002 the subjects were aged 62.6 ± 9.4 years, BMI was 26.4± 4.7 kg/m2, predicted FEV1 was 59.0 ±16.0, and mean actual height was 167.3±8.9cm. The actual height changed significantly (p<0.001) by 2cms over time in both genders. Whilst the overall classifications of the cohort did not change significantly when armspan was used to determine height and hence normal lung volume, individual cases did move to a classification of higher severity.
The study suggests that current measured height may underestimate the degree of impairment of FEV1 and hence progression of COPD. The use of height, derived from armspan, may give a more accurate measure of ‘normal’ lung volumes and hence the degree of impairment.