RESUMO
OBJECTIVE: To determine the frequency of spirometry in elderly people, by age group, at a pulmonary function clinic, to assess the quality of spirometry in the extremely elderly, and to determine whether chronological age influences the quality of spirometry. METHODS: This was a cross-sectional retrospective study evaluating information (spirometry findings and respiratory questionnaire results) obtained from the database of a pulmonary function clinic in the city of Aracaju, Brazil, for the period from January of 2012 to April of 2017. In the sample as a whole, we determined the total number of spirometry tests performed, and the frequency of the tests in individuals ≥ 60 years of age, ≥ 65 years of age, and by decade of age, from age 60 onward. In the extremely elderly, we evaluated the quality of spirometry using criteria of acceptability and reproducibility, as well as examining the variables that can influence that quality, such a cognitive deficit. RESULTS: The sample comprised a total of 4,126 spirometry tests. Of those, 961 (23.30%), 864 (20.94%), 102 (2.47%), and 26 (0.63%) were performed in individuals ≥ 60, ≥ 65, ≥ 86, and ≥ 90 years of age (defined as extreme old age), respectively. In the extremely elderly, the criteria for acceptability and reproducibility were met in 88% and 60% of the spirometry tests (95% CI: 75.26-100.00 and 40.80-79.20), respectively. The cognitive deficit had a negative effect on acceptability and reproducibility (p ≤ 0.015 and p ≤ 0.007, respectively). CONCLUSIONS: A significant number of elderly individuals undergo spirometry, especially at ≥ 85 years of age, and the majority of such individuals are able to perform the test in a satisfactory manner, despite their advanced age. However, a cognitive deficit could have a negative effect on the quality of spirometry.
Assuntos
Pulmão/fisiopatologia , Doenças Respiratórias/diagnóstico , Doenças Respiratórias/fisiopatologia , Espirometria/normas , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Disfunção Cognitiva , Comorbidade , Estudos Transversais , Feminino , Volume Expiratório Forçado/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pico do Fluxo Expiratório , Reprodutibilidade dos Testes , Doenças Respiratórias/psicologia , Estudos Retrospectivos , Fatores Sexuais , Espirometria/métodos , Espirometria/psicologia , Capacidade Vital/fisiologiaRESUMO
ABSTRACT Objective: To determine the frequency of spirometry in elderly people, by age group, at a pulmonary function clinic, to assess the quality of spirometry in the extremely elderly, and to determine whether chronological age influences the quality of spirometry. Methods: This was a cross-sectional retrospective study evaluating information (spirometry findings and respiratory questionnaire results) obtained from the database of a pulmonary function clinic in the city of Aracaju, Brazil, for the period from January of 2012 to April of 2017. In the sample as a whole, we determined the total number of spirometry tests performed, and the frequency of the tests in individuals ≥ 60 years of age, ≥ 65 years of age, and by decade of age, from age 60 onward. In the extremely elderly, we evaluated the quality of spirometry using criteria of acceptability and reproducibility, as well as examining the variables that can influence that quality, such a cognitive deficit. Results: The sample comprised a total of 4,126 spirometry tests. Of those, 961 (23.30%), 864 (20.94%), 102 (2.47%), and 26 (0.63%) were performed in individuals ≥ 60, ≥ 65, ≥ 86, and ≥ 90 years of age (defined as extreme old age), respectively. In the extremely elderly, the criteria for acceptability and reproducibility were met in 88% and 60% of the spirometry tests (95% CI: 75.26-100.00 and 40.80-79.20), respectively. The cognitive deficit had a negative effect on acceptability and reproducibility (p ≤ 0.015 and p ≤ 0.007, respectively). Conclusions: A significant number of elderly individuals undergo spirometry, especially at ≥ 85 years of age, and the majority of such individuals are able to perform the test in a satisfactory manner, despite their advanced age. However, a cognitive deficit could have a negative effect on the quality of spirometry.
RESUMO Objetivo: Determinar a frequência de idosos que realizaram espirometria num serviço de função pulmonar, e avaliar a qualidade da realização do exame na velhice extrema e se a idade cronológica influencia essa qualidade. Métodos: Estudo transversal retrospectivo utilizando informações (espirometria e questionário respiratório) de um banco de dados de um serviço de função pulmonar em Aracaju (SE) entre janeiro de 2012 e abril de 2017. Com base na amostra geral, determinou-se o número total de espirometrias realizadas em todas as idades, em idosos ≥ 60 anos, ≥ 65 anos, e por década de idade a partir da sexta década. Na velhice extrema, avaliou-se a qualidade da espirometria utilizando critérios de aceitabilidade e reprodutibilidade, e investigaram-se variáveis que influenciam essa qualidade, tal como déficit cognitivo. Resultados: A amostra geral foi composta por 4.126 espirometrias. Dessas, 961 (23,30%), 864 (20,94%), 102 (2,47%) e 26 (0,63%) foram realizadas em idosos com ≥ 60 anos de idade, ≥ 65 anos, ≥ 86 anos e ≥ 90 anos (velhice extrema), respectivamente. Na velhice extrema, os critérios de aceitabilidade e reprodutibilidade foram preenchidos em 88% (IC95%: 75,26-100,00) e 60% (IC95%: 40,80-79,20) das espirometrias, respectivamente. O déficit cognitivo influenciou negativamente a aceitabilidade e a reprodutibilidade (p ≤ 0,015; e p ≤ 0,007, respectivamente). Conclusões: Idosos na velhice extrema são uma realidade atual nos serviços de função pulmonar, e a maioria deles é capaz de realizar espirometrias adequadamente, apesar da idade avançada. O déficit cognitivo influencia negativamente a qualidade da espirometria.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doenças Respiratórias/diagnóstico , Doenças Respiratórias/fisiopatologia , Espirometria/métodos , Espirometria/normas , Pulmão/fisiopatologia , Doenças Respiratórias/psicologia , Espirometria/psicologia , Envelhecimento/fisiologia , Comorbidade , Pico do Fluxo Expiratório , Fatores Sexuais , Capacidade Vital/fisiologia , Volume Expiratório Forçado/fisiologia , Estudos Transversais , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores Etários , Disfunção CognitivaRESUMO
OBJECTIVE: To evaluate the acceptability and reproducibility of spirometry in preschool children; to estimate the effect size of early termination of exhalation (ETE) on FVC, FEV(1) and FEV(0.5); and to evaluate the validity of FEV(0.5) in curves with ETE. METHODS: Spirometric data were obtained from 240 healthy preschool children, who were selected by simple sampling. On the basis of the best curve from each child according to the end of exhalation, three groups were formed: no ETE (nETE); ETE and flow ≤ 10% of the highest PEF (ETE≤10); and ETE and flow > 10% of the highest PEF value (ETE>10). The reproducibility of FVC, FEV(1) and FEV(0.5) was compared among the three groups. The effect of ETE on FVC, FEV(1), and FEV(0.5) was assessed. RESULTS: Of the 240 children tested, 112 (46.5%)-82 (34.0%) of those in the nETE group and 30 (12.5%) of those in the ETE≤10 group--had acceptable curves for all the parameters. In 64 (27.0%) of those in the ETE>10 group, the curves were acceptable only for FEV(0.5), increasing the proportion of children with valid FEV(0.5) to 73.0%. There were no significant differences between the nETE and ETE≤10 groups in terms of the mean values of the parameters assessed. CONCLUSIONS: Maneuvers with ETE and flow ≤ 10% of the highest PEF are valid. In individuals with a flow > 10% of the highest PEF value, these maneuvers are only valid for FEV(0.5).
Assuntos
Expiração/fisiologia , Transtornos Respiratórios/diagnóstico , Testes de Função Respiratória/normas , Asma/diagnóstico , Criança , Pré-Escolar , Estudos Transversais , Feminino , Volume Expiratório Forçado , Humanos , Masculino , Estudos Prospectivos , Valores de Referência , Reprodutibilidade dos Testes , Testes de Função Respiratória/métodos , Espirometria/psicologiaRESUMO
OBJETIVO: Avaliar a aceitabilidade e a reprodutibilidade da espirometria em pré-escolares; estimar o tamanho do efeito da terminação precoce da expiração (TPE) nos valores de CVF, VEF1 e VEF0,5; e avaliar a validade do VEF0,5 em curvas com TPE. MÉTODOS: Espirometrias foram obtidas em 240 pré-escolares saudáveis, selecionados por amostragem simples. Três grupos foram formados com base na melhor curva de cada criança de acordo com o término da expiração: sem TPE (sTPE); com TPE e fluxo < 10 por cento do maior PFE (TPE<10); e com TPE e fluxo > 10 por cento do maior PFE (TPE>10). Foram comparadas a reprodutibilidade da CVF, VEF1 e VEF0,5 nos três grupos. Foi avaliado o efeito da TPE em CVF, VEF1 e VEF0,5. RESULTADOS: Das 240 crianças testadas, 112 (46.5 por cento) realizaram curvas aceitáveis para todos os parâmetros - 82 (34,0 por cento) no grupo sTPE e 30 (12,5 por cento) no grupo TPE<10. Em 64 (27,0 por cento) no grupo TPE>10, as curvas foram aceitáveis apenas para VEF0,5, aumentando para 73,0 por cento a proporção de crianças com VEF0,5 válido. Não houve diferenças significantes nas médias dos parâmetros avaliados entre os grupos sTPE e TPE<10. CONCLUSÕES: Manobras com TPE e fluxo < 10 por cento do maior PFE são válidas. Em indivíduos com fluxo > 10 por cento do maior PFE, essas manobras são válidas somente para VEF0,5.
OBJECTIVE: To evaluate the acceptability and reproducibility of spirometry in preschool children; to estimate the effect size of early termination of exhalation (ETE) on FVC, FEV1 and FEV0.5; and to evaluate the validity of FEV0.5 in curves with ETE. METHODS: Spirometric data were obtained from 240 healthy preschool children, who were selected by simple sampling. On the basis of the best curve from each child according to the end of exhalation, three groups were formed: no ETE (nETE); ETE and flow < 10 percent of the highest PEF (ETE<10); and ETE and flow > 10 percent of the highest PEF value (ETE>10). The reproducibility of FVC, FEV1 and FEV0.5 was compared among the three groups. The effect of ETE on FVC, FEV1, and FEV0.5 was assessed. RESULTS: Of the 240 children tested, 112 (46.5 percent)-82 (34.0 percent) of those in the nETE group and 30 (12.5 percent) of those in the ETE<10 group-had acceptable curves for all the parameters. In 64 (27.0 percent) of those in the ETE>10 group, the curves were acceptable only for FEV0.5, increasing the proportion of children with valid FEV0.5 to 73.0 percent. There were no significant differences between the nETE and ETE<10 groups in terms of the mean values of the parameters assessed. CONCLUSIONS: Maneuvers with ETE and flow < 10 percent of the highest PEF are valid. In individuals with a flow > 10 percent of the highest PEF value, these maneuvers are only valid for FEV0.5.
Assuntos
Criança , Pré-Escolar , Feminino , Humanos , Masculino , Expiração/fisiologia , Transtornos Respiratórios/diagnóstico , Testes de Função Respiratória/normas , Asma/diagnóstico , Estudos Transversais , Volume Expiratório Forçado , Estudos Prospectivos , Valores de Referência , Reprodutibilidade dos Testes , Testes de Função Respiratória/métodos , Espirometria/psicologiaRESUMO
RATIONALE: Disparities in pediatric asthma exist in that Latino children have higher prevalence and greater morbidity from asthma than non-Latino white children. The factors behind these disparities are poorly understood, but ethnic-related variations in children's ability to accurately recognize and report their pulmonary functioning may be a contributing process. OBJECTIVES: To determine (1) if differences exist between Latino and non-Latino white children's perceptual accuracy and (2) whether these differences are related to asthma outcomes. METHODS: Five hundred and twelve children, aged 7-16 years (290 island Puerto Ricans, 115 Rhode Island Latinos, and 107 Rhode Island non-Latino white children) participated in a 5-week home-based protocol in which twice daily they entered subjective estimates of their peak expiratory flow rate into a hand-held, programmable spirometer and then performed spirometry. Their accuracy was summarized as three perceptual accuracy scores. Demographic data, asthma severity, intelligence, emotional expression, and general symptom-reporting tendencies were assessed and covaried in analyses of the relationship of perceptual accuracy to asthma morbidity and health care use. MEASUREMENTS AND MAIN RESULTS: Younger age, female sex, lower intelligence, and poverty were associated with lower pulmonary function perception scores. Island Puerto Rican children had the lowest accuracy and highest magnification scores, followed by Rhode Island Latinos; both differed significantly from non-Latino white children. Perceptual accuracy scores were associated with most indices of asthma morbidity. CONCLUSIONS: Controlling for other predictive variables, ethnicity was related to pulmonary function perception ability, as Latino children were less accurate than non-Latino white children. This difference in perceptual ability may contribute to recognized asthma disparities.