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Point of Care Portable Spirometry in the Diagnosis and Treatment of Inpatients with Chronic Obstructive Pulmonary Disease

Abstract

Introduction

Spirometry is required to accurately diagnose chronic obstructive pulmonary disease (COPD). Following an acute exacerbation, it is recommended that spirometry be performed after a delay of 4–6 weeks to allow stability and a measure of ‘baseline’ lung function. However, poor attendance at these appointments can occur, leading to an inability to confirm the diagnosis of COPD or assess the severity of airflow obstruction. Portable spirometry (PS) is a proven surrogate device that may provide a convenient method to address these issues. The purpose of this study was to compare PS values, obtained prior to hospital discharge to laboratory-based spirometry (LS) results undertaken 4 weeks later.

Methods

Thirty-three eligible inpatients with a clinically determined exacerbation of COPD were recruited. Patients underwent PS prior to discharge and LS 4 weeks later.

Results

Reliability of PS values at discharge compared with outpatient LS 4 weeks later was excellent (intraclass correlation coefficient > 0.9). The PS confirmed a new diagnosis of COPD at the bedside in 29% of patients and excluded COPD in 6% at both time points. Patients were found to have a similar severity of airflow obstruction on both PS and LS, with clinical stability maintained between visits. The PS and LS may be used interchangeably for earlier diagnosis of COPD. PS at the point of discharge from hospital offers a unique opportunity to diagnose and facilitate COPD management from hospital to primary care.

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Funding

This research received no external funding.

Author information

Donald Tran was involved in formal analysis, investigation, writing original draft presentation and its subsequent review and editing. Melvin Lim was involved in constructing methodology, investigation, review and editing of manuscript, supervision of project and project administration. Sara Vogrin was involved in formal analysis and review and editing of manuscript. Lata Jayaram was involved in conceptualization, constructing methodology, investigation, review and editing of manuscript, supervision of project and project administration.

Correspondence to Lata Jayaram.

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Tran, D., Lim, M., Vogrin, S. et al. Point of Care Portable Spirometry in the Diagnosis and Treatment of Inpatients with Chronic Obstructive Pulmonary Disease. Lung 198, 143–150 (2020). https://doi.org/10.1007/s00408-019-00314-4

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Keywords

  • COPD
  • Portable spirometry
  • Inhaled corticosteroids