Chest
ORIGINAL RESEARCHCOPDDo Symptoms Predict COPD in Smokers?
Section snippets
Study Population
Subjects were recruited from a cohort referred for a work-related medical evaluation from 1980 to 2008 that included a questionnaire, chest radiographs, and pulmonary function tests. The cohort originally was described in 2004.12 Referrals were drawn from trade unions and television and newspaper advertisements. Cigarette smoking was quantified by pack-years. Subjects were queried about the presence and duration of symptoms, such as cough, sputum, dyspnea on exertion, and wheeze, on most days
Study Population Demographics
Smokers with obstruction were older, smoked more, and experienced more symptoms than smokers with restrictive or normal spirometry (P < .001) (Tables 1, 2). Few smokers had a remote history of lung cancer (Fig 1). In the 1,269 subjects with obstructed spirometry, 86% were GOLD stages II to IV. BMI was significantly greater in restricted smokers compared with all other smoking groups and lower in smokers with obstruction compared with smokers with normal spirometry (P < .05) (Table 1). Only
Discussion
This study shows that AO is common in long-term smokers aged > 40 years but is infrequently recognized by health-care workers. The prevalence of symptoms is high among smokers with AO, but they are not sensitive, specific, or predictive of AO. There is a statistically significant association of both symptoms and smoking history with the presence of AO. The addition of symptoms to smoking history improves diagnostic yield marginally in a complicated statistical model but not enough to make them
Acknowledgments
Author contributions: All authors provided intellectual input to the research and manuscript. All authors contributed equally.
Dr Ohar: contributed the idea of the paper and was the primary writer.
Dr Sadeghnejad: contributed to methods and statistical analysis.
Dr Meyers: contributed to supervision of statistical analysis.
Dr Donohue: contributed to supervision of clinical methods and assessments.
Dr Bleecker: contributed to supervision of clinical methods and assessments.
Financial/nonfinancial
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Funding/Support: The creation of the database was funded in part by the Selikoff Fund at Saint Louis University. Data analysis was funded in part by Spiromics Clinical Center [NIH HHSN 268200900019C].
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