Utility of FEV1/FEV6 index in patients with multimorbidity hospitalized for decompensation of chronic diseases

• Published in: PloS one 2019-08, Vol.14 (8), p.e0220491-e0220491
• Main Authors: Komal, Shakeel, Simon, Lluis, Grau, Gemma, Mateu, Aina, de la Asunción Villaverde, Maria, de la Sierra, Alex, Almagro, Pere
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Airway management; Airway Obstruction - diagnosis; Airway Obstruction - physiopathology; Biology and Life Sciences; Chronic Disease; Chronic illnesses; Chronic obstructive pulmonary disease; Cognitive ability; Comorbidity; Dysphagia; Female; Forced Expiratory Volume - physiology; Frailty; Geriatrics; Heart failure; Hospitalization; Hospitals; Humans; Impairment; Internal medicine; Male; Mathematical analysis; Medicine; Medicine and Health Sciences; Mental disorders; Multimorbidity; Older people; Patients; People and Places; Portable equipment; Primary care; Questionnaires; Research and Analysis Methods; Respiratory distress syndrome; Respiratory tract; Socioeconomic factors; Spirometry; Vital Capacity - physiology
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0220491

Spirometry remains essential for the diagnosis of airway obstruction. Nevertheless, its performance in elderly hospitalized patients with multimorbidity can be difficult. The aim of this study is to assess the utility of the COPD-6 portable device in this population. We included all patients hospitalized for exacerbation of chronic diseases in a medical ward specialized in the care of multimorbidity patients, between September 2017 and May 2018. A questionnaire including sociodemographic, cognitive and functional impairment, among other variables, was completed the last day of admission. Subsequently, patients attempted to perform three valid respiratory manoeuvres with the COPD-6 device and then conventional spirometry. A total of 184 patients were included (mean age of 79.61 years, 55% men). Forty-seven (25.54%) patients were able to perform complete spirometric manoeuvres and 99 (53.8%) could perform a valid FEV1/FEV6 determination. The inability to perform a valid spirometry was related with the patient's age, functional physical disability, cognitive impairment or the presence of delirium or dysphagia during admission. Only 9% of patients with a Mini Mental Cognitive Examination (MMEC) lower than 24 points could perform a valid spirometry. Of the patients with an MMEC < 24 points and unable to perform spirometry, 34% were able to complete the FEV1/FEV6 manoeuvres. No differences were found in the Charlson index, multimorbidity scale, number of domiciliary drugs, or length of stay between those patients able and those not able to perform respiratory manoeuvres. The agreement between the values for FEV1 measured with COPD-6 and those observed in the spirometry was good (r: 0.71; p