@article {BialasPA5058, author = {Adam Bialas and Kamil Kornicki and Maciej Ciebiada and Milkowska - Dymanowska Joanna and Wojciech Piotrowski and Adam Antczak and Pawel Gorski}, title = {FEV1/FEV3 ratio as an alternative to fixed ratio of FEV1/FVC}, volume = {52}, number = {suppl 62}, elocation-id = {PA5058}, year = {2018}, doi = {10.1183/13993003.congress-2018.PA5058}, publisher = {European Respiratory Society}, abstract = {Introduction: The quality of spirometric performance tends to decrease with age, often leading to unsatisfactory results. Forced vital capacity measurement (FVC) is especially difficult in the elderly, what may lead to diagnostic pitfalls. Forced expiratory volume in 3 seconds (FEV3) seems to be easier to obtain, and we hypothesized that FEV1/FEV3 ratio would be an alternative to FEV1/FVC in diagnosis of airflow limitation.Methods: Technically valid spirometry results of patients aged \>65 years old were retrospectively analysed. We used receiver operating characteristics (ROC) to assess the accuracy of FEV1/FEV3 in comparison with FEV1/FVC, and to identify the FEV1/FEV3 cut-off value. Concordance between airflow limitation diagnosis by analysed ratios thresholds was assessed by Cohen{\textquoteright}s kappa statistics.Results: 4877 spirometry results of 1983 males and 2894 females were included in the study. The median age was 71.45 (IQR:67.7-76.65) years. The prevalence of airway obstruction, defined as FEV1/FVC\<0.70 was 56.9\%. FEV1/FEV3 ratio showed excellent accuracy in diagnosing airflow limitation, with area under the ROC curve 0.97 (95\%CI:0.97-0.98). FEV1/FEV3\<0.78 was defined as a cut-off point. Cohen{\textquoteright}s kappa statistics showed a very good agreement between the cut-offs for analysed ratios (κ=0.83;95\%CI:0.82-0.85).Conclusion: FEV1/FEV3 ratio would be used as an alternative to fixed ratio of FEV1/FVC\<0.7 in diagnosing airflow limitation in the elderly, when a reliable measurement of FVC is difficult to obtain. However, these results should be confirmed in prospective study with calculation of lower limit of normal for FEV3, and analysed using GLI equations.FootnotesCite this article as: European Respiratory Journal 2018 52: Suppl. 62, PA5058.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/52/suppl_62/PA5058}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }