Spirometric Analysis of Clinically Diagnosed Asthma by Primary Physician and Correlation with BMI
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 5
Abstract
Background: Chronic dyspnea, defined as shortness of breath lasting longer than one month is a common clinical presentation. Spirometry provides good functional assessment of lung and helps in diagnosis for the cause and is of great help especially in overweight/obese individuals to rule out an over-diagnosis of common respiratory disease like asthma. The aim of the present study was to evaluate patients of chronic dyspnea using spirometry to first classify them into obstructive/restrictive/mixed patterns. To further analyze the study population categorized by sex and BMI based on various spirometric variables, make a specific diagnosis and then study the effect of BMI. Methods: 186 patients, who visited the T.B. and Chest OPD of Rajendra Institute of Medical Sciences(RIMS), Ranchi with features of chronic dyspnea, were included in the study. A detailed clinical history, clinical examination and spirometry were done in all patients included. A repeat Post-bronchodilator spirometry was performed in those showing an abnormal pattern. Study population was categorized on sex and BMI. Obstructive/restrictive/mixed patterns were identified and specific diagnosis was made using additional investigations where required. Response to bronchodilator was recorded. Overall pattern, distribution and disease association with BMI was studied. Results: Most symptomatic patients including both sexes were in the overweight (63 males & 27 females), followed by normal BMI (46 males & 26 females). 66.5% Subjects whose spirometric findings were abnormal were subjected to a post-bronchodilator spirometry. There was a statistically significant difference (p<0.05) in the lung volumes (FEV1 %, FEV3 %),and vital capacity (FVC %) among diseased and non-diseased. Majority of patients presenting with chronic dyspnea were overweight and normal. Overall an obstructive pattern was the most common in all BMI groups (67/186 cases), followed by restrictive (31) and mixed(25) patterns. Obstructive pattern was most common in overweight(31/90 cases). Restrictive pattern was most frequent in the obese group (5/24 cases). Asthma was the most common diagnosis overall (42 cases), closely followed by COPD (39 cases). Lung parenchymal damage was seen in 19 cases and Pleural & chest wall deformity in 13 cases. COPD was most frequently diagnosed in the normal and overweight BMI group whereas asthma was more frequent in the obese group. Conclusion: Spirometry is a reliable tool in assessing the physiological lung function of patients presenting with chronic dyspnea and can be helpful in differentiating the etiology. The use of Spirometry must be encouraged in the Indian population to prevent over-diagnosis of Asthma which has clinical symptoms similar to several other respiratory disorders. Both Obstructive and Restrictive lung disorders are associated with higher BMI. Not all symptomatic cases show spirometric abnormalities. In cases where spirometry is contraindicated or PFT findings are inconclusive, additional investigations should help in diagnosis.
Authors and Affiliations
Dr. Brajesh Mishra, Dr. Apoorv Sinha, Dr. Shashi Bhushan Singh
Keywords
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- EP ID EP597554
- DOI 10.9790/0853-160506120125.
- Views 73
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