https://doi.org/10.4081/monaldi.2024.3099

Prediction of spirometry outcome in Croatian patients with chronic obstructive pulmonary disease

Early Access
Submitted: June 25, 2024
Accepted: September 20, 2024
Published: November 15, 2024
COPD, spirometry parameters, general linear model, multiple linear regression, stepwise regression, factorial analysis
Abstract Views: 0
PDF_EARLY VIEW: 0
SUPPLEMENTARY MATERIAL: 0
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Erim Bešić
https://orcid.org/0000-0002-1116-4655
Faculty of Pharmacy and Biochemistry, University of Zagreb, Croatia.
Davorka Muršić
https://orcid.org/0000-0002-0793-3343
Clinic for Respiratory Diseases, University Hospital Center Zagreb, Croatia.
Tajana Jalušić Glunčić
Clinic for Respiratory Diseases, University Hospital Center Zagreb, Croatia.
Jelena Ostojić
https://orcid.org/0000-0002-0314-331X
Clinic for Respiratory Diseases, University Hospital Center Zagreb, Croatia.
Sanda Škrinjarić-Cincar
Faculty of Medicine, University of Osijek, Croatia.
Martina Dokoza
Department of Internal Medicine, Zadar General Hospital, Croatia.
Nataša Karamarković Lazarušić
Polyclinic for the Respiratory Tract Diseases, Zagreb, Croatia.
Miroslav Samaržija
Clinic for Respiratory Diseases, University Hospital Center Zagreb; School of Medicine, University of Zagreb, Croatia.
Andrea Vukić Dugac
adugac71@gmail.com
https://orcid.org/0000-0002-1522-3325
Clinic for Respiratory Diseases, University Hospital Center Zagreb; School of Medicine, University of Zagreb, Croatia.

The current study offers an extensive examination of the influence of 29 diverse parameters on spirometry measurement variables in a cohort of 534 patients with chronic obstructive pulmonary disease (COPD) from five different centers in Croatia. The study elucidates both the magnitude and direction of the effect exerted by the 29 predictors on forced vital capacity (FVC), forced expiratory volume in one second (FEV1), the ratio FEV1/FVC, and predicted forced expiratory flow at 50% of FVC. Additionally, the development of prediction models for these parameters has been undertaken using several statistical methods. The study identifies fat-free mass index, 6-minute walk distance, predicted diffusing capacity of the lung for carbon monoxide, arterial partial pressure of oxygen, and both arterial and tissue hemoglobin oxygen saturation percentage as robust positive predictors for all four spirometry parameters. Body mass index is recognized as a weak positive predictor for FEV1 and FEV1/FVC, commonly observed in COPD patients. As expected, smoking years is identified as a strong negative predictor for all four spirometry parameters, while age and illness duration exhibit strong predictive negative associations. Furthermore, modified medical research council, arterial partial pressure carbon dioxide, St George's respiratory questionnaire, COPD assessment test, depression anxiety stress scales, and nutritional risk screening are identified as weak negative predictors. Charlson comorbidity index, phase angle, and number of comorbidities do not exhibit a significant impact on spirometry variables. Ultimately, the performed factorial analysis categorized the 29 parameters into five groups, which were identified as relating to lung function, health status, nutritional status, age, and smoking. Multiple regression analysis, including four newly derived parameters based on the results of factorial analysis, identified nutritional status as a positive predictor for spirometry readings, while smoking, poor health status, and age were identified as negative predictors in successive order.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of COPD. 2021 report. Available from: https://goldcopd.org/wp-content/uploads/2020/11/GOLD-REPORT-2021-v1.1-25Nov20_WMV.pdf.
Halpin DMG, Celli BR, Criner GJ, et al. The GOLD Summit on chronic obstructive pulmonary disease in low- and middle-income countries. Int J Tuberc Lung Dis 2019;23:1131-41.
Lopez-Campos JL, Tan W, Soriano JB. Global burden of COPD. Respirology 2016;21:14-23.
GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018;392:1736-88.
Pellegrino R, Viegi G, Brusasco V, et al. Interpretative strategies for lung function tests. Eur Respir J 2005;26:948-68.
Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J 2005;26:319-38.
Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2023 report. Available from: https://goldcopd.org/2023-gold-report-2/.
Miller MR, Crapo R, Hankinson J, et al. General considerations for lung function testing. Eur Respir J 2005;26:153-61.
Guerra S, Sherrill DL, Kurzius-Spencer, M, et al. The course of persistent airflow limitation in subjects with and without asthma. Respir Med 2008;102(10):1473-82.
Hankinson JL, Odencrantz JR, Fedan KB. Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med 1999;159:179-87.
Holguin F, Folch E, Redd SC, Mannino DM. Comorbidity and mortality in COPD-related hospitalizations in the United States, 1979 to 2001. Chest 2017;128:2005-11.
Pellegrino R, Viegi G, Brusasco V. Interpretative strategies for lung function tests. Eur Respir J 2005;26:948-68.
Stanojevic S, Wade A, Stocks J, et al. Reference ranges for spirometry across all ages: a new approach. Am J Respir Crit Care Med 2008;177:253-60.
Miura S, Iwamoto H, Omori K, et al. Accelerated decline in lung function in adults with a history of remitted childhood asthma. Eur Respir J 2022;59(1):2100305-15.
Quanjer PH, Stanojevic S, Cole TJ, et al. Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations. Eur Respir J 2012;40:1324-43.
Swanney MP, Jensen RL, Crichton DA, et al. FEV(6) is an acceptable surrogate for FVC in the spirometric diagnosis of airway obstruction and restriction. Am J Respir Crit Care Med 2000;162:917-9.
Burney PG, Laitinen LA, Perdrizet S, et al. Validity and repeatability of the IUATLD (1984) bronchial symptoms questionnaire: an international comparison. Eur Respir J 1989;2:940-5.
Sin DD, McAlister FA, Man SF, Anthonisen NR. Contemporary management of chronic obstructive pulmonary disease: scientific review. JAMA 2003;290:2301-12.
Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary. Am J Respir Crit Care Med 2017;195:557-82.
Muršić D, Jalušić Glunčić T, Ostojić J, et al. Differences in nutritional status of patients with chronic obstructive pulmonary disease between Mediterranean and non-Mediterranean regions in Croatia. Monaldi Arch Chest Dis 2023;93:2667. DOI: 10.4081/monaldi.2023.2667.
Muršić D, Jalušić Glunčić T, Ostojić J, et al. Body composition, pulmonary function tests, exercise capacity, and quality of life in chronic obstructive pulmonary disease patients with obesity. Postgrad Med J 2024;100:469-74.
Kyle UG, Bosaeus I, De Lorenzo AD, et al. Bioelectrical impedance analysis—part I: review of principles and methods. Clin Nutr 2004;23:1226-43.
Pinto-Plata VM, Cote C, Cabral H, et al. The 6-min walk distance: change over time and value as a predictor of survival in severe COPD. Eur Respir J 2004;23:28-33.
Spruit MA, Polkey MI, Celli B, et al. Predicting outcomes from 6-minute walk distance in chronic obstructive pulmonary disease. J Am Med Dir Assoc 2012;13:291-7.
Pitta F, Troosters T, Spruit MA, et al. Characteristics of physical activities in daily life in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2005;171:972-7.
Graham BL, Brusasco V, Burgos F, et al. 2017 ERS/ATS standards for single-breath carbon monoxide uptake in the lung. Eur Respir J 2017;49:1600016.
Li Y, Li XY, Yuan LR, et al. Evaluation of small airway function and its application in patients with chronic obstructive pulmonary disease (Review). Exp Ther Med 2021;22:1386-94.
Abd-Allah HM, Abdalla H, Ahmed S, Mohammed MH. Role of single breath diffusing capacity for carbon monoxide in patients with chronic obstructive pulmonary disease. Al-Azhar Assiut Med J 2021;19:61-7.
Choi J, Sim JK, Oh JY, et al. Prognostic marker for severe acute exacerbation of chronic obstructive pulmonary disease: analysis of diffusing capacity of the lung for carbon monoxide (DLCO) and forced expiratory volume in one second (FEV1). BMC Pulm Med 2021;21:152.
Celli BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 2004;350:1005-12.
Viegi G, Pedreschi M, Pistelli F, et al. Prevalence of airways obstruction in a general population: European Respiratory Society vs American Thoracic Society definition. Chest 2000;117:330-45.
Schols AM, Broekhuizen R, Weling-Scheepers CA, Wouters EF. Body composition and mortality in chronic obstructive pulmonary disease. Am J Clin Nutr 2005;82:53-9.
Marquis K, Debigaré R, Lacasse Y, et al. Midthigh muscle cross-sectional area is a better predictor of mortality than body mass index in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2002;166:809-13.
Vestbo J, Prescott E, Almdal T. Body mass, fat-free body mass, and prognosis in patients with chronic obstructive pulmonary disease from a random population sample: findings from the Copenhagen City Heart Study. Am J Respir Crit Care Med 2006;173:79-83.
Maltais F, Decramer M, Casaburi R, et al. An official American Thoracic Society/European Respiratory Society statement: update on limb muscle dysfunction in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2014;189:e15-62.
Landbo C, Prescott E, Lange P, et al. Prognostic value of nutritional status in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1999;160:1856-61.
Spelta F, Fratta Pasini AM, Cazzoletti L, et al. Body weight and mortality in COPD: focus on the obesity paradox. Eat Weight Disord 2018;23:15-22.
Schols AM, Slangen J, Volovics L, Wouters EF. Weight loss is a reversible factor in the prognosis of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998;157:1791-7.
Casanova C, de Torres JP, Aguirre-Jaime A, et al. The body mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. Chest. 2005;128:911-9. DOI: 10.1378/chest.128.2.911
Knudson RJ, Lebowitz MD, Holberg CJ, Burrows B. Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis 1983;127:725-34.
Lange P, Celli B, Agustí A, et al. Lung-function trajectories leading to chronic obstructive pulmonary disease. N Engl J Med 2015;373:111-22.
Jones PW, Harding G, Berry P, et al. Development and first validation of the COPD Assessment Test. Eur Respir J 2009;34:648-54.
Pauwels RA, Buist AS, Calverley PM, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: NHLBI/WHO global initiative for chronic obstructive lung disease (GOLD) workshop summary. Am J Respir Crit Care Med 2001;163:1256-76.
Cazzola M, Macklem PT, Stolz D. Unmet needs in COPD: a vision for the future. Int J Chron Obstruct Pulmon Dis 2008;3:411-29.
de Torres JP, Casanova C, Hernandez C, et al. Gender and COPD in patients attending a pulmonary clinic. Chest 2005;128:2012-6.
Wan ES, Balte P, Schwartz JE, et al. Association between preserved ratio impaired spirometry and clinical outcomes in US adults. JAMA 2021;326:2287-98.
Zhang N, Lin Q, Jiang H, et al. Age-adjusted Charlson Comorbidity Index as effective predictor for in-hospital mortality of patients with cardiac arrest: a retrospective study. BMC Emerg Med 2023;23:7.
Quan H, Li B, Couris CM, et al. Updating and validating the Charlson Comorbidity Index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol 2011;173:676-82.
Valisoltani N, Mohammadi H, Aliannejad R, et al. Association of phase angle with sarcopenia and muscle function in patients with COPD: a case-control study. BMC Pulm Med 2024;24:18.
Ruiz-Margáin A, Xie JJ, Román-Calleja BM, et al. Phase angle from bioelectrical impedance for the assessment of sarcopenia in cirrhosis with or without ascites. Clin Gastroenterol Hepatol 2021;19:1941-9.e2.

Ethics Approval

The study protocol was approved by the Ethical Review Committee of the University of University Hospital Centre Zagreb (ID 02/18 AG) as well as by the Ethical Committee of the University Hospital Centre Rijeka, the University Hospital Centre Osijek and Zadar General Hospital.

How to Cite

Bešić, Erim, Davorka Muršić, Tajana Jalušić Glunčić, Jelena Ostojić, Sanda Škrinjarić-Cincar, Martina Dokoza, Nataša Karamarković Lazarušić, Miroslav Samaržija, and Andrea Vukić Dugac. 2024. “Prediction of Spirometry Outcome in Croatian Patients With Chronic Obstructive Pulmonary Disease”. Monaldi Archives for Chest Disease, November. https://doi.org/10.4081/monaldi.2024.3099.
Copyright (c) 2024 The Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.


Similar Articles

<< < 2 3 4 5 6 7 8 9 10 11 > >> 

You may also start an advanced similarity search for this article.