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The usefulness of dyspnea rating in evaluation for pulmonary impairment/disability in patients with chronic pulmonary disease

Authors :
Yoon Soo Chang
Hyun Myung Cho
Kang Hyun Ahn
Won Young Lee
Sung Kyu Kim
Joon Chang
Se Kyu Kim
Jae Min Park
Jun Gu Lee
Young Sam Kim
Source :
Tuberculosis and Respiratory Diseases. 46:204
Publication Year :
1999
Publisher :
The Korean Academy of Tuberculosis and Respiratory Diseases, 1999.

Abstract

Background: Resting pulmonary function tests(PFTs) are routinely used in the evaluation of pulmonary impairment/disability. But the significance of the cardiopulmonary exercise test(CPX) in the evaluation of pulmonary impairment is controvertible. Many experts believe that dyspnea, though a necessary part of the assessment, is not a reliable predictor of impairment. Nevertheless, oxygen requirements of an organism at rest are different from at activity or exercising, and a clear relationship between resting PFTs and exercise tolerance has not been established in patients with chronic pulmonary disease. As well, the relationship between resting PFTs and dyspnea is complex. To investigate the relationship of dyspnea, resting PFTs, and CPX, we evaluated the patients of stabilized chronic pulmonary disease with clinical dyspnea rating(baseline dyspnea index, BDI), resting PFTs, and CPX. Method: The 50 patients were divided into two groups: non-severe and severe group on basis of results of resting PFTs(by criteria of ATS), CPX(by criteria of ATS or Ortega), and dyspnea rating(by focal score of BDI). Groups were compared with respect to pulmonary function, indices of CPX, and dyspnea rating. Results: 1. According to the criteria of pulmonary impairment with resting PFTs, max, and focal score of BDI were significantly low in the severe group(pmax(ml/kg/min) and max(%), the parameters of resting PFTs, except were not significantly different between non-severe and severe(p>0.05). According to focal score((%), FVC(%), MW(%), , and max were significantly lower in the severe group(pmax(ml/kg/min) and max(%) were low(p(%) was correlated with max(%)(r=0.52;pmax and max WR. Therefore, if not contraindicated, CPX would be considered to evaluate the severity of pulmonary impairment in patients with chronic pulmonary diseases, including with severe resting PFTs. Current criteria used to evaluate the severity of impairment were insufficient in considering the degree of dyspnea, so new criteria, including the severity of dyspnea, may be necessary.

Details

ISSN :
03780066
Volume :
46
Database :
OpenAIRE
Journal :
Tuberculosis and Respiratory Diseases
Accession number :
edsair.doi...........5454822d969f6d4e0d9eb73b10b51d60
Full Text :
https://doi.org/10.4046/trd.1999.46.2.204