Predictive value of spirometry in early detection of obstructive lung disease in adults: a cohort study

Background: Spirometry is essential to identify cases with obstructive lung diseases in primary care. However, knowledge about the long-term prognostic outcome among younger individuals is sparse.Aim: To describe the predictive value of spirometry among individuals in the age groups 30-49 (the 1991 cohort) and 45-64 (the 2006 cohort).Method: Spirometry was performed in 905 adults (30-49 years) in 1991 and in 1277 middle-aged persons (45-64 years) in 2006. The participants were categorised into three groups; FEV1/FVC < 70, 70 – 75 and >75 and followed throughout 2017 using Danish national registries. Lung disease was defined if fulfilling at least one of the following: 1) two prescriptions for respiratory medicine were redeemed within a year, 2) one lung-related contact to the hospital, 3) lung-related death.Results: In the 1991 cohort, 21% developed lung diseases and in the 2006 cohort 17% developed lung diseases throughout 2017. The probability of developing lung disease if FEV1/FVC: 70-75, was 35% (95% CI: 25% - 44%) in the 1991 cohort and 23% (95% CI: 17% - 28%) in the 2006 cohort. The positive predicted value was higher for both cohorts, when focusing on smoking history and self-reported respiratory symptoms.Conclusion: The initial spirometry has a high predictive value to identify individuals at risk of future lung diseases. In addition, the group with FEV1/FVC: 70 – 75 had a high risk of developing lung diseases later in life, suggesting this group would be a meaningful target of special interest.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 2402.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).