Clinical variables are poor selection criteria for the use of methacholine bronchoprovocation in symptomatic subjects.
Respir Care
; 48(6): 596-601, 2003 Jun.
Article
en En
| MEDLINE
| ID: mdl-12780946
ABSTRACT
OBJECTIVE:
Airway hyperresponsiveness (AHR) is associated with persistent air flow limitation and accelerated FEV(1) decline. AHR can influence diagnosis, treatment, and prognosis. We assessed the value of pulmonary function variables, symptoms, and history as selection criteria for methacholine bronchoprovocation testing to detect AHR in symptomatic subjects.METHODS:
Over a 4-year period we conducted a prospective study of consecutive subjects who underwent methacholine bronchoprovocation testing. Baseline pulmonary function testing (PFT) and a questionnaire were obtained prior to methacholine bronchoprovocation testing. PFT and symptom and history variables were assessed as AHR predictors in univariate and multiple logistic regression analyses for the whole group and for 4 different age groups.RESULTS:
There were 530 subjects, with ages ranging from 5 to 87 years, and 232 (44%) were positive for methacholine AHR. AHR was more prevalent among subjects < or = 25 years old (59%) and > 65 years old (47%) than among the other age groups. PFT values, symptom, and history variables had different AHR predictive values among the different age groups. Symptom and history variables had no AHR predictive value among subjects < or = 25 or > 65 years old.CONCLUSIONS:
Young and elderly symptomatic subjects are more likely to have methacholine AHR. None of the clinical variables we studied has significant predictive value for methacholine AHR across the age groups, so these variables are poor selection criteria for methacholine bronchoprovocation testing of symptomatic subjects. Given the high prevalence of AHR among these subjects, bronchoprovocation should be considered with all individuals who have respiratory symptoms of wheezing, cough, shortness of breath, or chest tightness.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Pruebas de Función Respiratoria
/
Hipersensibilidad Respiratoria
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Pruebas de Provocación Bronquial
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Broncoconstrictores
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Cloruro de Metacolina
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Selección de Paciente
Tipo de estudio:
Diagnostic_studies
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Evaluation_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Aged
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Aged80
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Child
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Child, preschool
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Humans
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Middle aged
Idioma:
En
Revista:
Respir Care
Año:
2003
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
EEUU
/
ESTADOS UNIDOS
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ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
/
UNITED STATES OF AMERICA
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US
/
USA