TY - JOUR T1 - The value of spirometry to diagnose a restrictive pattern JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - P1264 AU - Liliana Raposo AU - António Bugalho Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/P1264.abstract N2 - Background: The assessment of total lung capacity (TLC) is the gold standard to detect a restrictive pattern. However, in some cases, patients are subjected only to spirometry and a low forced vital capacity (FVC) with a normal FEV1/FVC ratio is classified as restriction.Objectives: Determine the value of FVC measured by spirometry to diagnose a restrictive abnormality and identify FVC cut-off values that may predict a restrictive pattern.Methods: Spirometry and plethysmography results from 1.937 adult patients who undertook both tests in the same appointment were evaluated in a retrospective study. All patients with a normal or low FVC (<80% predicted), with a normal FEV1/FVC (>70%) and a normal or low TLC (<80% predicted) were included. Patients with a low FEV1/FVC associated to an obstructive or mixed pattern were excluded. Subgroups were created based on gender and FVC degree of severity.Results: A total of 374 patients (19.3%) had a restrictive pattern, mean age was 57.8 years and 189 were females (50.5%). FVC determined by spirometry had a 48.5% sensibility, 95.6% specificity, 80% positive predictive value (PPV) and 83.3% negative predictive value (NPV) to detect restriction. The best cut-off values to determine a restrictive impairment were FVC<60% predicted in males (PPV 97.3% and NPV 12.2%) and FVC<50% predicted in females (PPV 100% and NPV 25.7%).Conclusion: Spirometry is able to correctly diagnose a restrictive pattern in specific subgroups of patients according to FVC severity. These results may help clinicians, especially in primary care, to decide which patients need to perform additional lung measurements. ER -