jsmc-10168

THE CORRELATION OF SPIROMETRY AND CHEST X-RAY WITH RESPIRATORY SYMPTOMS

Jihad Ibrahim a and Kamaran Karadakhy b

a Kurdistan Board of Medical Specialties Candidate.

b Department of Medicine, College of Medicine, University of Sulaimani. 

Submitted: 25/2/2018; Accepted: 12/8/2018; Published 15/10/2018

DOI Link: https://doi.org/10.17656/jsmc.10168 

ABSTRACT

Background 

Concerning relationship between respiratory symptoms, spirometry and chest X-ray, the relationship has been both underestimating and overestimating in the diagnosis and treatment.

Objectives 

To show the correlation between symptoms and the findings on different parameters of chest X-ray, spirometry, weight, gender, and age.

Methods

A case-control study has been done in Sulaimani city. The cases have visited the Respiratory Center at SHAR- teaching Hospital in Sulaimania- Iraq from June 1st, 2017 to December 1st, 2017. 146 cases with respiratory symptoms and 72 asymptomatic subjects served as a control group. A simple respiratory questionnaire has been used, Body Mass Index, Spirometry (Spirometry from both CareFusion and Mir air) and chest X-ray at the Radiological Department at SHAR-teaching Hospital. Age was between 12 and 70 years, undiagnosed respiratory diseases previously, mentally clear: understand how he/she can perform spirometry.

Results 

A total of (218) subjects, (146) cases and (72) controls were enrolled. Mean age of (39.7) years for cases and (49.23) years for control group. Gender distribution, both cases and control groups are relatively well matched with (68%) males Vs (32%) females in cases and (72%) males Vs (28%) females among the control group. Smoking habit (30.8%) cases Vs (40.2%) control. SPO2% was same in both groups. Chest X Ray findings: Cases (96%) had unremarkable CXR, (1.37%) hyper inflated pattern, (1.37%) Bilateral Hilar Enlargement (BHE), and a single (0.68%) cardiomegaly. Control group( 93%) had unremarkable CXR, (1.38% )hyper inflated pattern and (5.55%) cardiomegaly. Spirometry findings cases (88.35%) normal and (11.65% )obstructive pattern. While control groups (97.22% )normal and (2.78%) restrictive pattern. Dyspnea ( 87%), cough (68%), sputum (36 %), wheeze (17 %) most common symptoms.

Conclusion

The respiratory symptoms and CXR findings had a strong relation to both age and smoking. Spirometry is more symptomatic dependent than CXR. BMI and gender showed no significant differences between the two groups.

KEYWORDS

Spirometry, Chest X-Ray, Dyspnea, Wheeze, Cough.

References 

1. Helen K Reddel (Chair, GINA Science Committee). Søren Pedersen (Chair, GINA Board of Director)- Global Initiative for Asthma, Gina- Asthma Guideline, 2017 Report. www.ginasthma.org.

2. Huib A M Kerstjens, Bert Rijcken, Jan P Schouten, Dirkje S. Postman. Decline of FEV1 by age and smoking status: facts, figures, and fallacies. Thorax 1997; 52:820–82

3. Vocal Cord Dysfunction (VCD) or Paradoxical Vocal Fold Movement (PVFM)-a special report about VCD and asthma mimic symptoms. www.aaaai.org ,2017

4. Alvar Augusti (chair, GOLD Board of Directors). Claus Vogelmeier(Chair, GOLD Science Committee). Global Initiative for chronic Obstructive Lung Disease-GOLD-COPD guideline 2018.www.goldcopd.org

5. Mark J. Rosen. Bronchiectasis. Chronic Cough Due to Bronchiectasis ACCP Evidence-Based Clinical Practice Guidelines. CHEST 2006; 129:122S–131S

6. Nicotra MB, Rivera M, Dale AM, et al. Clinical, pathophysiologic, and microbiologic characterization of bronchiectasis in an aging cohort. American college of chest physician. Chest. 1995; 108:955-961.

7. Ellis HC, Cowman S, Fernandes M, et al. Predicting mortality in bronchiectasis using bronchiectasis severity index and FACED scores: a 19-year cohort study. European Respiratory Society.Eur Respir J. 2016;47:482-489.

8.  Enright PL, Studnicka M, Zielinski J. Spirometry to detect and manage chronic obstructive pulmonary disease and asthma in the primary care setting. European respiratory monograph. 2005 Apr 1;31:1.

9. Gershon AS, Victor JC, Guan J, Aaron SD, To T. Pulmonary function testing in the diagnosis of asthma: a population study. Chest. 2012 May 1;141(5):1190-6.

10. Cardinale L, Priola AM, Moretti F, Volpicelli G. Effectiveness of chest radiography, lung ultrasound and thoracic computed tomography in the diagnosis of congestive heart failure. World journal of radiology. 2014 Jun 28;6(6):230.

11. Wielpütz MO, Heußel CP, Herth FJ, Kauczor HU. Radiological diagnosis in lung disease: factoring treatment options into the choice of diagnostic modality. Deutsches Ärzteblatt International. 2014 Mar;111(11):181.

12. Izamin Idris, MPH, Mohd Rizal Abdul Manaf Chest X-Ray As an Essential Part of Routine Medical Examination: Is It Necessary?. Med J Malaysia Vol 67 No 6 December 2012

13. Sally Stapley, Deborah Sharp, and William Hamilton; Negative chest X-rays in primary care patients with lung cancer; British Journal of General Practice, August 2006

14. Mark O. Wielpütz, Claus P. Heußel, Felix J. F. Herth, Hans-Ulrich Kauczor Radiological Diagnosis in Lung Disease Factoring Treatment Options into the Choice of Diagnostic Modality …Deutsches Ärzteblatt International | Dtsch Arztebl Int 2014; 111(11): 181-7

15. Jackie Campbell; Michelle Pyer Stephen Rogers David Walter Raja ReddyEnabling patients with respiratory symptoms to access chest X-rays on demand.The experience of the walk-in service in Corby, UK; Journal of Public Health, Volume 36, Issue 3, 1 September 2014, Pages 511–516,

16. Rossi OV; Lähde S; Laitinen J; Huhti E Contribution of chest and paranasal sinus radiographs to the management of acute asthma. ; MEDLINE Abstract; Int Arch Allergy Immunol.  1994; 105(1):96-100 (ISSN: 1018-2438) 

17. Azadeh Ebrahimzadeh ; Mahyar Mohammadifard ; Godratallah Naseh ; Alireza Mirgholami Clinical and Laboratory Findings in Patients with Acute Respiratory Symptoms that Suggest the Necessity of Chest X-ray for Community Acquired Pneumonia. Iran J Radiol. 2015;12(1):e13547

18. Izamin Idris, MPH, Mohd Rizal Abdul Manaf Chest X-Ray As an Essential Part of Routine Medical Examination: Is It Necessary?. Med J Malaysia Vol 67 No 6 December 2012

19. Mats Arne, Karin Lisspers, Bjorn Stallberg Gunnar Boman, Hans Hedenstrom , Christer Janson, Margareta Emtner How often is diagnosis of COPD confirmed with spirometry?. Respiratory Medicine (2010) 104, 550e556

20. Michael XV Owens, William McD. Anderson , Ronald B.George. Indications for Spirometry in Outpatients with Respiratory Disease: Volume 99, Issue 3, March 1991, Pages 730-734; 

21. Wisnivesky J, Skloot G, Rundle A, Revenson TA, Neugut A.Spirometry screening for airway obstruction in asymptomatic smokers.Aust Fam Physician. 2014 Jul;43(7):463-7

22. Amany F. Elbehairy,Grace Parraga,Katherine A. Webb, J Alberto Neder &Denis E. O’DonnellMild chronic obstructive pulmonary disease: why spirometry is not sufficient!; Expert Review of Respiratory Medicine Volume 11, 2017 - Issue 7

23. Golpe R, Díaz-Fernández M, Mengual-Macenlle N, Sanjuán-López P, Martín-Robles I, Cano-Jiménez ESemergen. 2017 Nov- Dec;43(8):557-564..Over-diagnosis of chronic obstructive pulmonary disease in Primary Care. Prevalence and determining factors].PubMed ; 

24. Sau Nga Fu. Wai Cho Yu. Carlos King-Ho Wong. Margaret Choi-Hing Lam.Prevalence of undiagnosed airflow obstruction among people with a history of smoking in a primary care setting. International Journal of COPD 2016:11 2391–2399. 

25. Irwin RS, French CL, Chang AB, Altman KW, Adams TM, Azoulay E, Barker AF, Birring SS, Blackhall F, Bolser DC, Boulet LP. Classification of Cough as a Symptom in Adults and Management Algorithms: CHEST Guideline and Expert Panel Report. Chest. 2018 Jan 1;153(1):196-209

26. Tarlo SM, Altman KW, Oppenheimer J, Lim K, Vertigan A, Prezant D, Irwin RS, Adams TM, Azoulay E, Barker AF, Birring SS. Occupational and environmental contributions to chronic cough in adults: CHEST expert panel report. Chest. 2016 Oct 1;150(4):894-907.

27. Bernhardt V, Babb TG. Respiratory symptom perception differs in obese women with strong or mild breathlessness during constant-load exercise. Chest. 2014 Feb 1;145(2):361-9.

28. Naz S, Aziz T, Umair MM, Uzair MM. Chest X-ray: An unfair screening tool. Journal of Ayub Medical College Abbottabad. 2014 Dec 1;26(4):554-8

29. Pearce N. Analysis of matched case-control studies. BMJ. 2016 Feb 25;352:i969.

30.  Lewallen S, Courtright P. Epidemiology in practice: case-control studies. Community Eye Health. 1998;11(28):57.

31.  Allan S. Brett,  Detterbeck FC et al. 2013 ACCP Guideline on Screening for Lung Cancer; Chest 2013 May

32.  Gabriela Lewin, Kate Morissette, James Dickinson, Neil Bell, Maria Bacchus, Harminder Singh, Marcello Tonelli, Alejandra Jaramillo Garcia.Recommendations on screening for lung cancer Canadian Task Force on Preventive Health Care* CMAJ, April 5, 2016, 188(6), DOI:10.1503 /cmaj.151421.

33. Zammit C, Liddicoat H, Moonsie I, Makker H. Obesity and respiratory diseases. International journal of general medicine. 2010;3:335.

34. Janney CA, Kilbourne AM, Germain A, Lai Z, Hoerster KD, Goodrich DE, Klingaman EA, Verchinina L, Richardson CR. The influence of sleep-disordered breathing on weight loss in a national weight management program. Sleep. 2016 Jan 1;39(1):59-65.

35. World Health Organization. Obesity: preventing and managing the global epidemic. World Health Organization; 2000.

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