The course of clinical COPD in Thailand
Charoenpan, P.; Kiatboonsri, S.; Saenghirunvattana, S.; Aursudkij, B.; Vathesatogkit, P.; Vongvitat, K.
Journal of the Medical Association of Thailand 75(6): 320-327
1992
ISSN/ISBN: 0125-2208 PMID: 1487679 Document Number: 392691
Spirometry and outcome of 96 cases who were clinically diagnosed as having COPD were studied. Ninety-two cases had significant airway obstruction. Of these 92 cases, initial bronchodilator responses were evaluated in 73 cases. Twenty-six cases were responders (CRAO), while 47 cases were nonresponders (COPD). The average median survival of the whole group was 4 years and 5-year survival was 30 per cent. The annual change in FEV-1 in both COPD and CRAO group were fluctuating with a tendency to decrease in the former and increase in the latter. Spirometric parameters were found to be different between the survivors and nonsurvivors, these included initial PFEV-1 PFVC, PFEF 25-75 per cent and postbronchodilator FEV-1 and FEF 25-75 per cent. Inspite of the differences, an initial response to bronchodilator could not predict a better outcome for CRAO as compared to COPD. It was concluded that most clinical COPD who had progressive symptoms had significant airway obstruction and shorter survival. Due to fluctuating FEV-1 during the course, the initial spirometry and degree of bronchodilator response were not accurate enough to predict subsequent outcome. Long-term follow-up on spirometry and response to bronchodilator should be individually evaluated.