Obstructive Lung Diseases: Airways 5 |

The Association Between the Level of COPD Severity and Hyperinflation FREE TO VIEW

Bernadette Magnaye; Aileen Guzman-Banzon, MD; Maria Encarnita Limpin, MD; Teresita DeGuia, MD
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Philippine Heart Center, Quezon City, Philippines

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):883A. doi:10.1016/j.chest.2016.08.983
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: To determine the level of COPD severity associated with hyperinflation. To determine COPD severity. To determine TLC, RV and RV/TLC. To determine and compare the TLC, RV and RV/TLC among different levels of COPD severity.

METHODS: This was a prospective cohort analytic study among COPD patients diagnosed by pulmonary function test with post-bronchodilator study FEV1/FVC ratio of < 0.70, consistent with airflow obstruction. Lung volume study was done among those who do not have lung volume study. An analysis of variance were used for the association of TLC, RV and RV/TLC ratio on the different levels of COPD severity based on GOLD citeria. A p- value of ≤ 0.05 was considered significant.

RESULTS: Seventy-four patients were included in the study. Fifty-nine patients (80 %) were males and 15 (20 %) were females. The mean age of the study population was 62 years old with mean height of 160.01 + 8.4 cm and weight of 61.43 + 15.8 kg. Majority of the patients (93 %) were smoker, with mean average pack-year-smoker of 30.93 + 22.1 pack-year. Five patients (7%) who have no smoking history were majority males (4 males and 1 female). The mean FEV1 was 52 % predicted in the post-bronchodilator study. Most of the patients were at GOLD 2 with 33 patients (45%), followed by GOLD 3 with 30 patients ( 40%), then GOLD 4 with 6 patients (8%) and GOLD 1 with 5 patients (7%). Lung volume parameters such as TLC and RV across all stages showed the presence of hyperinflation based on cut-off values using the lower limit of normality but was not statistically significant. On the other hand, RV/TLC ratio was associated with hyperiflation to all GOLD stages, GOLD 1 (40.8 + 9.8), GOLD 2 (50.73 + 11.2), GOLD 3 (54.87 + 9.07) and GOLD 4 (62.33 + 3.56) with a p- value of 0.0027 which was statistically significant. An increasing trend of RV/TLC as COPD category increases was noted. However, looking at the changes between one category to the next, the change in RV/TLC was significantly increased between GOLD 1 and 3 (p value of 0.043) and GOLD 1 and 4 (p value of 0.008) only.

CONCLUSIONS: In conclusion, hyperinflation was more significantly noted using RV/TLC as the objective parameters and only when patients are in COPD GOLD 3 and 4 category.

CLINICAL IMPLICATIONS: RV/TLC ratio as shown in the study was vital for identifying patients who will have severe and frequent exacerbations across all COPD category. Thus, this could help the physician give aggresive and appropriate treatment early on the disease stage to prevent future exacerbations, functional deterioration and costly hospitalization.

DISCLOSURE: The following authors have nothing to disclose: Bernadette Magnaye, Aileen Guzman-Banzon, Maria Encarnita Limpin, Teresita DeGuia

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