title: Spirometry for patients in hospital and one month after admission with an acute exacerbation of COPD.
abstract: OBJECTIVE
  To assess whether spirometry done in hospital during an admission for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is clinically useful for long-term management.
  
  
  METHODS
  Patients admitted to hospital with a clinical diagnosis of AECOPD had spirometry post-bronchodilator at discharge and approximately 4 weeks later.
  
  
  RESULTS
  Spirometry was achieved in less than half of those considered to have AECOPD. Of 49 patients who had spirometry on both occasions, 41 met the GOLD criteria for COPD at discharge and 39 of these met the criteria at 1 month. For the 41, spirometry was not statistically different between discharge and 1 month but often crossed arbitrary boundaries for classification of severity based on FEV(1). The eight who did not meet GOLD criteria at discharge were either misclassified due to comorbidities that reduce FVC, or they did not have COPD as a cause of their hospital admission.
  
  
  CONCLUSIONS
  Spirometry done in hospital at the time of AECOP is useful in patients with a high pre-test probability of moderate-to-severe COPD. Small changes in spirometry at 1 month could place them up or down one grade of severity. Spirometry at discharge may be useful to detect those who warrant further investigation.
authors: Section of Integrated Care, South Auckland Clinical School, University of Auckland, Auckland, New Zealand.
authors: Harry
authors: H
authors: Rea
authors: Timothy
authors: T
authors: Kenealy
authors: Jacqui
authors: J
authors: Adair
authors: Elizabeth
authors: E
authors: Robinson
authors: Nicolette
authors: N
authors: Sheridan
mesh_terms: D000368:Aged; D001993:Bronchodilator Agents / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000187:drug effects / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010343:Patient Admission; D010351:Patient Discharge; D011237:Predictive Value of Tests; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D012720:Severity of Illness Index; D013147:Spirometry; D013997:Time Factors; D016896:Treatment Outcome; D014797:Vital Capacity
chemical_list: D001993:Bronchodilator Agents