Quality of spirometry in the elderly

Abstract

Introduction: Spirometry is the basic method used to diagnose and monitor obstructive diseases. Spirometric tests are performed in more and more people of advanced age (more than 65 years old). The objective of the study was to assess the quality of spirometry (measurement of the flow-volume curve) in subjects of the aforementioned age group, with reference to applicable quality criteria specified in guidelines ERS/ATS 2005 and PTChP 2006.

Material and methods: The study was of a retrospective nature. The authors analysed the results of spirometry performed in 1271 subjects who were 65 to 94 years old and who underwent spirometric tests in the Respiratory Physiopathology Laboratory of Kujawy-Pomorze Regional Centre of Pulmonology in Bydgoszcz over a period of 6 months. This group included 759 males (average age 73.2 ± 5.9 years) and 512 females (average age 73.2 ± 5.7 years). The quality of the spirometry was assessed according to error codes assigned to individual spirometric sessions by the software JLab 5.31 installed in the measuring system MasterScreen (CareFusion).

Results: Twenty-nine (2.3%) of the 1271 subjects failed to perform spirometric measurements. For the remaining 1242 subjects the following spirometry quality was determined: correctly performed spirometric test in 415 (33.4%) subjects; one error in 673 (54.2%) subjects; 2 errors in 136 (11%) subjects; 3 errors in 15 (1.2%) subjects and 4 errors in 3 (0.2%) subjects. The analysis of individual errors revealed that the lack of a plateau at the end of exhalation was found in 747 (60.1%) subjects (including only 25 (2%) subjects with FET < 6 s); increased BEV value in 7 (0.6%) subjects; abruptly finished exhalation in 36 (2.9%) subjects; and no FVC and FEV₁ repeatability in 43 (3.5%) and 169 (13.6%) subjects, respectively.

Conclusions: The most common error was the lack of a plateau at the end of exhalation. Therefore, paying particular attention to the final phase of exhalation during spirometry should, as a result, increase the percentage of correctly performed spirometric tests in the elderly.