Bronchial airflow limitation and chest findings in adults with respiratory infection.
OBJECTIVE
To study the predictive value of clinical chest findings for bronchial airflow limitation in patients with respiratory tract infection.


METHODS
Associations were analysed between FEV1 (forced expiratory volume in one second) in % of predicted and physical chest findings.


METHODS
The Municipal Emergency Clinic in Tromsø, Norway.


METHODS
398 adult patients with respiratory tract infection and 40 general practitioners.


METHODS
Mean FEV1% predicted and frequency of FEV1 < 80% predicted according to chest findings. Regression coefficients of the findings with FEV % predicted as outcome variable.


RESULTS
Mean FEV1% predicted was 87 (range 25-129). Pathological chest findings were recorded in 127 patients (32%) and in 22 of the 24 patients (92%) with FEV1% predicted less than 60. The 78 patients with wheezes had a mean FEV1% predicted of 74 (range 29-120), significantly lower than those without wheezes (p < 0.0001), and 63% had FEV1% predicted less than 80. Prolonged expiration or strenuous respiration was recorded in 49 patients. The 29 patients with wheezes in this subgroup had a significantly lower mean FEV1% predicted, 65, than the 20 patients without wheezes (p < 0.005). By multiple regression wheezes and strenuous respiration were the most significant predictors of FEV1% predicted, together with patients' statement of very annoying dyspnoea.


CONCLUSIONS
When predicting the degree of bronchial obstruction in a patient with respiratory infection, the doctor may take into account wheezes heard by auscultation, an impression of strenuous respiration, and the patient's statement about severe dyspnoea.
Melbye
H
H
Institute of Community Medicine, University of Tromsø, Norway.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D011237:Predictive Value of Tests; D012123:Pulmonary Ventilation; D012135:Respiratory Sounds; D012141:Respiratory Tract Infections / Q000150:complications / Q000503:physiopathology*; D013147:Spirometry