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Correlation between symptoms, chest radiographs, pulmonary function tests and severity of emphysema on autopsy lungs in elderly patients
Author(s) -
Motegi Takashi,
Kida Kozui,
Kudoh Shoji
Publication year - 2005
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/j.1447-0594.2005.00265.x
Subject(s) - medicine , chest radiograph , pulmonary function testing , pathological , radiography , body mass index , lung , physical examination , autopsy , respiratory system , cardiology , radiology
Background: In general, the clinical features of chronic obstructive pulmonary disease in the elderly are complicated, frequently resulting in undiagnosed disorders. It would be convenient if simple parameters to screen for the disease were developed. The present study investigated the pathological–clinical inter‐relationships in emphysema. Methods: A total of 121 cases were graded by severity of emphysema into five groups according to the panel grid system. Grades were then compared with various clinical parameters including the severity of respiratory symptoms, characteristics of physical examination, measurements on chest radiographs and airflow obstruction on pulmonary function tests. Results: The mean age of patients was 77.1, and 71 cases (58.7%) were male. The severity distribution was as follows: no emphysema 20 (16.5%), and the four grades, ranging from mild to severe, were 65 (53.7%) grade I, 16 (13.2%) grade II, 13 (10.7%) grade III and seven (5.9%) cases were grade IV. Both smoking history (pack‐year) and body mass index were significantly correlated with emphysema severity. In addition, both respiratory symptoms and airflow obstruction were sharply and significantly increased in groups III + IV compared with groups I + II. On plain chest radiograph, the ratio of lung length to body height was significantly correlated with the severity of emphysema ( P < 0.01). Conclusions: We conclude that both respiratory symptoms and airflow obstruction are inter‐related and demarcate mild emphysema from that showing more than moderate severity. The number of cigarette pack‐years, loss of body weight and increased lung length on plain chest radiography might be useful indicators for speculated emphysema severity.