Evaluating the extremely elderly at a pulmonary function clinic for the diagnosis of respiratory disease: frequency and technical quality of spirometry.
Melo Saulo Maia d'Avila,Oliveira Larissa Alves de,Wanderley José Lucas Farias,Rocha Rodrigo Dos Anjos
Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia
OBJECTIVE:To determine the frequency of spirometry in elderly people, by age group, at a pulmonary function clinic, to assess the quality of spirometry in the extremely elderly, and to determine whether chronological age influences the quality of spirometry. METHODS:This was a cross-sectional retrospective study evaluating information (spirometry findings and respiratory questionnaire results) obtained from the database of a pulmonary function clinic in the city of Aracaju, Brazil, for the period from January of 2012 to April of 2017. In the sample as a whole, we determined the total number of spirometry tests performed, and the frequency of the tests in individuals ≥ 60 years of age, ≥ 65 years of age, and by decade of age, from age 60 onward. In the extremely elderly, we evaluated the quality of spirometry using criteria of acceptability and reproducibility, as well as examining the variables that can influence that quality, such a cognitive deficit. RESULTS:The sample comprised a total of 4,126 spirometry tests. Of those, 961 (23.30%), 864 (20.94%), 102 (2.47%), and 26 (0.63%) were performed in individuals ≥ 60, ≥ 65, ≥ 86, and ≥ 90 years of age (defined as extreme old age), respectively. In the extremely elderly, the criteria for acceptability and reproducibility were met in 88% and 60% of the spirometry tests (95% CI: 75.26-100.00 and 40.80-79.20), respectively. The cognitive deficit had a negative effect on acceptability and reproducibility (p ≤ 0.015 and p ≤ 0.007, respectively). CONCLUSIONS:A significant number of elderly individuals undergo spirometry, especially at ≥ 85 years of age, and the majority of such individuals are able to perform the test in a satisfactory manner, despite their advanced age. However, a cognitive deficit could have a negative effect on the quality of spirometry.
Pulmonary function test quality in the elderly: a comparison with younger adults.
Haynes Jeffrey M
BACKGROUND:Elderly patients may be at greater risk for misdiagnosis and inappropriate treatment as a consequence of pulmonary function test underutilization and tests being conducted with low quality expectations. This study sought to determine if elderly patients are able to achieve both spirometry and diffusion capacity (DLCO) quality scores comparable to a younger adult population. METHODS:This was a retrospective review of pulmonary function data over a 22 month period. A list of every subject age ≥ 80 years (elderly group) and ages 40-50 years (control group) tested during the time period was compiled. The quality of spirometry and DLCO testing were examined. RESULTS:Overall, 92.6% (139/150) of the elderly group and 91.5% (163/178) of the control group spirometry tests satisfied all American Thoracic Society/European Respiratory Society acceptability and reproducibility criteria (P = .84), and 84.9% (96/113) of the elderly group and 88.5% (108/122) of the control group DLCO tests satisfied all the acceptability and reproducibility criteria (P = .45). CONCLUSIONS:Elderly patients referred to a hospital-based pulmonary function test lab can be expected to achieve spirometry and DLCO quality scores comparable to younger adult patients.