[The practice of respiratory disability assessment in a university hospital: the analysis of 136 patients].
BACKGROUND
This study, to examine the outcomes of the respiratory disability assessment in our clinic.


METHODS
The reports of 136 patients who attended the chest diseases clinic between January 2010 and June 2011 for the assessment of the respiratory disability were examined retrospectively.


RESULTS
Of 10.457 patients who presented in 18 months, 136 (1.3%) requested the assessment of the respiratory disability. The patients' average age was 51 ± 12 years and 118 (87%) were male. Farmers constituted 19.8% of the patients and mine and foundry workers 10.7% of the patients. The most frequent symptoms were dyspnea (91.2%) and cough (76.5%). The most frequent radiological pattern was reticular and nodular opacities (38.2%). The workup led to a diagnosis of chronic obstructive pulmonary disease in 64 patients (47%) and of interstitial pulmonary disease/pneumoconiosis in 19 (14%) patients. No respiratory disease was found in 19 patients. Among 44 (32.4%) patients for whom disability rate was calculated, 8 (18.2%) had an incapacity rate of 60% or higher and 13 had 0%. The disability rates showed positive correlations with age, the duration of the respiratory symptoms and PaCO2 level (respectively r= 0.395, p= 0.008; r= 0.391, p= 0.009; r= 0.790, p< 0.001), and negative correlations with FVC, FEV1 and PaO2 levels (respectively r= -0.681, p< 0.001; r= -0.766, p< 0.001; r= -0.661, p= 0.003). Linear regression analysis showed that high PaCO2 value is a determinant for a high disability rate (r= 0.902, p= 0.014). Furthermore, smokers had higher disability rates than non-smokers (p< 0.001).


CONCLUSIONS
We believe that new evidence-based guidelines that will resolve the medicolegal and social obscurities are needed.
Department of Chest Diseases, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey. serdar_berk@mynet.com
Serdar
S
Berk
Gülizar Canan
GC
Sanlı
Sefa Levent
SL
Ozşahin
Omer Tamer
OT
Doğan
Sulhattin
S
Arslan
Ibrahim
I
Akkurt
D001784:Blood Gas Analysis; D003371:Cough; D004185:Disability Evaluation; D019317:Evidence-Based Medicine; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011009:Pneumoconiosis / Q000150:complications* / Q000175:diagnosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000175:diagnosis; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013147:Spirometry; D014797:Vital Capacity