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Interpretative consequences of adopting the global lungs 2012 reference equations for spirometry for children and adolescents
Author(s) -
Quanjer Philip H.,
Weiner Daniel J.
Publication year - 2014
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.22876
Subject(s) - spirometry , medicine , intensive care medicine , asthma
Summary Objective To determine the interpretative consequences of adopting the Global Lungs 2012 (GLI‐2012) spirometric prediction equations in a pediatric hospital population. Material Spirometric records from 2,192 white boys and 1,842 white girls, and 412 and 334 African–American boys and girls, respectively, aged 6.0–18.0 years, treated mainly for asthma, cystic fibrosis, cough, and dyspnoea. Methods Predicted values and lower limits of normal were calculated for FEV 1 , FVC, and FEV 1 /FVC, using prediction equations from GLI‐2012, Hankinson, Knudson, Polgar, Wang, and Zapletal. Obstruction was defined as FEV 1 /FVC < LLN, a restrictive pattern as FEV 1 /FVC > LLN and FVC < LLN. Results There was good agreement for predicted values for FEV 1 , FVC, and FEV 1 /FVC from GLI‐2012, Hankinson and Wang equations within ethnic groups. A near normal FEV 1 but above normal FVC contributed to a low FEV 1 /FVC, particularly in African–Americans. Polgar, Knudson, and Zapletal predicteds produced disparate results. A restrictive pattern occurred in 2.2–11.2% of cases, with no statistical difference between GLI‐2012 and Hankinson. Conclusions Transition from Hankinson and Wang equations to GLI‐2012 leads to grossly similar prevalence rates of abnormally low values for FEV 1 , FVC, and FEV 1 /FVC, unlike equations from Knudson, Polgar, and Zapletal. Pediatr Pulmonol. 2014; 49:118–125. © 2013 Wiley Periodicals, Inc.