Prevalence of airflow obstruction according GOLD, ATS and ERS criteria in symptomatic ever-smokers referring to a pulmonary rehabilitation department.

AIM: To evaluate in a Pulmonary Rehabilitation (PR) setting the prevalence of airflow obstruction (AO) in either current or former smokers > or = 45 years old both with dyspnoea and with chronic productive cough, using European Respiratory society (ERS) statement (FEV1/SVC < 88 and < 89% predicted in men and women, respectively), American Thoracic Society (ATS) statement (FEV1/FVC < 75%), and Global Initiative for Chronic Obstructive Lung Disease (GOLD) statement (FEV1/FVC < 70%).

METHODS

Lung function tests were performed in each patient who was referred to our PR department due to respiratory diagnosis or symptoms. For analysis, in patients showing AO we used post-bronchodilator lung function values.

RESULTS

In 184 ever-smoker patients with symptoms of chronic obstructive pulmonary disease (COPD), the prevalence rates of AO were as follows: ERS = 89.7%, ATS = 76.6%, and GOLD = 63.6%. Patients with AO according ERS criteria showing moderate to severe (M/S) obstruction (i.e., FEV1 < 70% predicted) were 119. Patients with ERS M/S AO but without AO using either ATS or GOLD criteria were 8.4% and 19.3%, respectively.

CONCLUSIONS

Prevalence of AO is highly dependent on which guidelines it is based. ATS and particularly GOLD statement can cause a large under-diagnosis even of moderate to severe COPD. Diagnosis of COPD may be overlooked if SVC is not performed.