Spirometric surveillance of obstructive lung diseases

Background: Obstructive Lung Disease (OLD) becomes global health issues that influencing the physical health and economic conditions of people. Chronic Respiratory Disease (CRD) is the disease of airways characterized by obstruction and influencing the structure of the lungs. It includes chronic bronchitis, COPD, emphysema and asthma. The most common disease is Chronic Obstructive Pulmonary Disease (COPD). The major causes of COPD involve exposure to an irritant that damage the lungs and airways that can cause such disease.Aim: 1):Assess the prevalence of OLD among the patients admitted to general medical wards using spirometry; 2): Use a symptom questionnaire for screening patients with OLD and compare it with Spirometry; 3): Association of various medical co-morbidities with the diagnosis of OLD.Materials and Methods: The screening for OLDs and factors that are influencing it along with co morbidities were analyzed. This is a descriptive study conducted on patients admitted to general medical wards in hospital of South India for a period of 2 years. The study has involved the patients who are admitted in general wards and aged > 40 years.Results: The physician diagnosis of OLD at admission was in 21 out of 144 patients. It was by symptom alone in 11% (16 of 144 patients) and based on spirometry in 3.48% (5 of 144) only. During the hospitalization the diagnosis of OLD increased by 2.08% (3 of 144) on the basis of symptom alone and 1.4% (2 of 144) by spirometry, cumulatively by 3.48% (5 of 144). Therefore, at admission about 14.48% were diagnosed to have OLD. An ROC curve was plotted and the area under the curve was 0.77 95% CI (0.688 — 0.865). By ROC coordinates a cut off of 15.5 for detecting OLDs showed a sensitivity and specificity of 71% and 78% respectively with a positive predictive value of 56% and negative predictive value of 87%.Conclusion: With the additional yield of Spirometry and association of medical comorbidities can help identify the conditions of patients earlier and pave way for offering appropriate holistic treatment.