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      International Journal of COPD (submit here)

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      Spirometry for patients in hospital and one month after admission with an acute exacerbation of COPD

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          Abstract

          Aim

          To assess whether spirometry done in hospital during an admission for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is clinically useful for long-term management.

          Methods

          Patients admitted to hospital with a clinical diagnosis of AECOPD had spirometry post-bronchodilator at discharge and approximately 4 weeks later.

          Results

          Spirometry was achieved in less than half of those considered to have AECOPD. Of 49 patients who had spirometry on both occasions, 41 met the GOLD criteria for COPD at discharge and 39 of these met the criteria at 1 month. For the 41, spirometry was not statistically different between discharge and 1 month but often crossed arbitrary boundaries for classification of severity based on FEV 1. The eight who did not meet GOLD criteria at discharge were either misclassified due to comorbidities that reduce FVC, or they did not have COPD as a cause of their hospital admission.

          Conclusion

          Spirometry done in hospital at the time of AECOP is useful in patients with a high pre-test probability of moderate-to-severe COPD. Small changes in spirometry at 1 month could place them up or down one grade of severity. Spirometry at discharge may be useful to detect those who warrant further investigation.

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          Author and article information

          Journal
          Int J Chron Obstruct Pulmon Dis
          International Journal of COPD
          International Journal of Chronic Obstructive Pulmonary Disease
          Dove Medical Press
          1176-9106
          1178-2005
          2011
          2011
          14 October 2011
          : 6
          : 527-532
          Affiliations
          [1 ]Section of Integrated Care, South Auckland Clinical School, University of Auckland, Auckland, New Zealand
          [2 ]Biostatistics and Epidemiology, School of Population Health, University of Auckland, Auckland, New Zealand
          [3 ]Section of Integrated Care, South Auckland Clinical School and School of Nursing, University of Auckland, Auckland, New Zealand
          Author notes
          Correspondence: Timothy Kenealy, Section of Integrated Care, South Auckland Clinical School, University of Auckland, Middlemore Hospital, Private Bag 93311, Otahuhu, Auckland 1640, New Zealand, Tel +64 9 276 0044 ext 8415, Fax +64 9 276 0066, Email t.kenealy@ 123456auckland.ac.nz
          Article
          copd-6-527
          10.2147/COPD.S24133
          3206769
          22069364
          e84f34c5-6f89-47be-8b26-7f81a2bec013
          © 2011 Rea et al, publisher and licensee Dove Medical Press Ltd.

          This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

          Categories
          Original Research

          Respiratory medicine
          acute exacerbation of copd,spirometry,cohort study,primary care,classification of copd

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