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Obstructive Lung Diseases |

Latent COPD Patients Should be Discovered by Preoperative Spirometry

Masanobu Watari, MD
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Hiroshima General Hospital, Hatsukaichi, Japan


Chest. 2013;144(4_MeetingAbstracts):701A. doi:10.1378/chest.1704126
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Abstract

SESSION TITLE: COPD Diagnosis & Evaluation Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: A lot of COPD patients remain undiscovered and untreated. It is said that about five million COPD patients are latent in Japan. Therefore, we need a new method to find latent COPD patients. If a numerous patients are discovered, they could receive the blessing of clinical medicine. Now, we have found out such a new method and introduce it.

METHODS: Spirometry, the diagnostic tool of COPD is usually performed to all surgical patients who receive the general anesthesia in Japan. We think of that preoperative spirometry provides a big chance to discover latent COPD patients. In 2011, preoperative spirometry was performed to 2,606 patients in our hospital, and 389 (14.9%) patients showed obstructive lung disorder ( FEV1/FVC<70%), most of them might be COPD. Thus, to discover COPD, Department of preoperative lung function improvement (DPLFI) was established in our hospital since July 2012. Physiological research staffs initially check patients who show obstructive lung disorder in spirometry, then recommend their own doctors to introduce them to DPLFI. Once COPD patients are discovered, they quit smoking, receive any bronchodilator and respiratory rehabilitation if needed during preoperative period. Spirometry is examined again on admission day, the data are compared with the before. Consequently, surgical tolerance is expected to improve. On discharge, patients are introduced to their family doctors, so that they can continue COPD treatment all their life.

RESULTS: During initial six months, preoperative spirometry was performed to 1,427 patients in our hospital, and 222 (15.6%) patients showed obstructive lung disorder (COPD I-IV). Since we had not enough staffs, patients were limited to COPD II-IV(103 patients). Whereas 48 patients consulted DPLFI, others were not introduced. As for 48 patients, FEV1/FCV improved (60.4% vs. 63.2% in average). All of 48 patients showed good clinical course.

CONCLUSIONS: Preoperative spirometry can provide a big chance to discover a numerous latent COPD patients. We have no choice to miss it.

CLINICAL IMPLICATIONS: This report gives big impact to medical staffs concerned with COPD.

DISCLOSURE: The following authors have nothing to disclose: Masanobu Watari

Investigation, procedure to discover COPD is presented.


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