Small airways obstruction syndrome in clinical practice

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background and objective: Small airways obstruction syndrome (SAOS) is a particular pulmonary function test (PFT) pattern showing decreased VC and FEV1 but a normal FEV1/VC ratio and TLC. The significance of this syndrome in clinical practice has not been comprehensively investigated. Methods: This study retrospectively identified all patients who had performed PFT that showed a SAOS pattern at a university teaching hospital over 1 year. A simple algorithm for differential diagnosis was developed and validated. Results: Of the 3207 PFT performed, 153 (4.8%) showed a pattern indicating SAOS. Among these, a final diagnosis was confirmed for 85 (63.4%) of the patients. The causes of SAOS included both restrictive and obstructive lung diseases with the leading causes being early interstitial lung disease (n = 20; 23.3%), chest wall deformity (n = 12; 14.1%) and asthma (n = 10; 11.6%). Using a cut-off point of TLC of <95% predicted value to identify restrictive ventilatory defects (P = 0.002) and of ≥95% predicted combined with RV/TLC ≥55% to identify obstructive ventilatory defects (P < 0.001), a simplified algorithm with good accuracy (86.6%) was identified. Validation in an independent group showed accuracy of 91%. Conclusions: The PFT pattern called SAOS is not uncommon. The most common causes of SAOS were early interstitial lung disease, chest wall deformity and asthma. A diagnostic algorithm was proposed, which may help physicians' decision-making in their daily practice.

Original languageEnglish
Pages (from-to)393-398
Number of pages6
JournalRespirology
Volume14
Issue number3
DOIs
Publication statusPublished - 2009 Apr 1

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Airway Obstruction
Respiratory Function Tests
Interstitial Lung Diseases
Thoracic Wall
Asthma
Obstructive Lung Diseases
Teaching Hospitals
Decision Making
Differential Diagnosis
Physicians

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

Cite this

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title = "Small airways obstruction syndrome in clinical practice",
abstract = "Background and objective: Small airways obstruction syndrome (SAOS) is a particular pulmonary function test (PFT) pattern showing decreased VC and FEV1 but a normal FEV1/VC ratio and TLC. The significance of this syndrome in clinical practice has not been comprehensively investigated. Methods: This study retrospectively identified all patients who had performed PFT that showed a SAOS pattern at a university teaching hospital over 1 year. A simple algorithm for differential diagnosis was developed and validated. Results: Of the 3207 PFT performed, 153 (4.8{\%}) showed a pattern indicating SAOS. Among these, a final diagnosis was confirmed for 85 (63.4{\%}) of the patients. The causes of SAOS included both restrictive and obstructive lung diseases with the leading causes being early interstitial lung disease (n = 20; 23.3{\%}), chest wall deformity (n = 12; 14.1{\%}) and asthma (n = 10; 11.6{\%}). Using a cut-off point of TLC of <95{\%} predicted value to identify restrictive ventilatory defects (P = 0.002) and of ≥95{\%} predicted combined with RV/TLC ≥55{\%} to identify obstructive ventilatory defects (P < 0.001), a simplified algorithm with good accuracy (86.6{\%}) was identified. Validation in an independent group showed accuracy of 91{\%}. Conclusions: The PFT pattern called SAOS is not uncommon. The most common causes of SAOS were early interstitial lung disease, chest wall deformity and asthma. A diagnostic algorithm was proposed, which may help physicians' decision-making in their daily practice.",
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Small airways obstruction syndrome in clinical practice. / Chen, Chiung Zuei; Lin, Chien Chung; Lee, Cheng Hung; Chang, Han Yu; Hsiue, Tzuen Ren.

In: Respirology, Vol. 14, No. 3, 01.04.2009, p. 393-398.

Research output: Contribution to journalArticle

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