Prognostic significance of surrogate measures for forced vital capacity in an elderly population.
OBJECTIVE
To evaluate whether measures easier to obtain than the FVC can substitute it as a prognostic marker in elderly people.


METHODS
Prospective, observational study.


METHODS
Community.


METHODS
Outpatients (n = 1485) aged 73.4 years (SD: 6.2 range 65-98) enrolled in the Salute Respiratoria nell'Anziano (SaRA) study.


METHODS
We calculated the risk for mortality associated with a reduction below 80% of the predicted FVC, of the forced expiratory volume at 6 seconds (FEV6), and of a surrogate measure for forced vital capacity (SFVC), defined as the largest volume exhaled in 2 forced maneuvers regardless of its duration and of the presence of plateau.


RESULTS
Among the 907 participants who attained the FVC, the mortality rate ratio (MRR) associated with having a low FVC, FEV6, and SFVC were 1.37 (95% CI: 0.91-2.00), 1.66 (95% CI: 1.15-2.36), and 1.28 (95% CI: 0.88-1.84), respectively. In those who could not obtain the FVC, mortality was more strongly associated with both low FEV6 (MRR: 3.02, 95% CI: 1.72-5.24) and low SFVC (MRR: 2.18; 95% CI: 1.53-3.10). The association between SFVC and mortality was present in the whole population, even after adjustment for age, gender, disability, mood, and cognitive status (MRR: 1.64; 95% CI: 1.29-2.09).


CONCLUSIONS
The SFVC provides similar prognostic information compared with the FVC, and is associated with increased mortality in the subgroup of patients not able to attain the FVC. This measure can make the respiratory assessment for prognostic purposes easier, especially in elderly patients who have a high prevalence of respiratory diseases, but frequently fail to perform an FVC maneuver complying with recommended standards.
Pedone
Claudio
C
Area di Geriatria, Università Campus Biomedico, Roma, Italy. c.pedone@unicampus.it
Bellia
Vincenzo
V
Sorino
Claudio
C
Forastiere
Francesco
F
Pistelli
Ricardo
R
Antonelli-Incalzi
Raffaelle
R
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D015415:Biomarkers; D006801:Humans; D007558:Italy; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013147:Spirometry; D016019:Survival Analysis; D014797:Vital Capacity / Q000502:physiology*
D015415:Biomarkers