The Korean Academy of Tuberculosis and Respiratory Diseases
422 32nd World Congress of Internal Medicine (October 24-28, 2014)
years in 69 of the 146 patients (47.3%) with follow up and in 78 of the 1058 patients (7.4%) without follow up. The percentages of emergency room visits, admissions, and intensive care unit admission were 7.2%, 21.7%, and 4.3%, respectively, in the patients with follow-up and 11.5%, 25.6%, and 7.7%, respectively, in the patients without follow-up. The cost of medical utilization was 278±501 US dollars per person and 5057±6539 dollars per person for outpatient and inpatient services, respectively, in patients with follow-up and 114±148 and 5854±5587, respectively, in patients without follow-up.
Conclusions: Mild COPD patients without the fi rst 2 years follow-up after diagnosis have higher economic burden than those with follow-up. Despite mild COPD, the early management of COPD is important from the economic point of view.
OS-047 COPD
Lung Function Variability in COPD
Han-Sol Choi1,2, Yeon Joo Lee1,2, Se Joong Kim1,2, Young-Jae Cho1,2, Jong Sun Park1,2, Jae-Ho Lee1,2, Choon-Taek Lee1,2, Ho Il Yoon1,2
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National Uni- versity Bundang Hospital, Korea1, Department of Internal Medicine, Seoul National University College of Medicine, Korea2
Background: Chronic obstructive pulmonary disease(COPD) has been traditionally considered as a slowly progressive disease. However, COPD is a complex and het- erogeneous disease with significant individual variability in its clinical, functional presentation. On the other hand, the variability of serial forced expiratory volume in one second (FEV1) in one patient is also known to be diverse. We sought to fi nd the meaning of FEV1 variability in stable COPD patients.
Methods: The Korean Obstructive Lung Disease (KOLD) Cohort Study is a long-term prospective longitudinal cohort of patients with COPD. FEV1 variability was defi ned as standard deviation of serial measurement of FEV1 in each subject (measured at 3, 6, 9, 12, 18 and 24 month from baseline visit). One hundred and twenty one patients were divided into two subgroups by FEV1 variability (stationary group N=61, variable group N=60). Then we analysed the difference in functional, clinical outcome parameters between the two groups.
Results: Initial modifi ed medical research council(mMRC) score and saint George’s res- piratory questionnaire(SGRQ) score were signifi cantly better in variable group (P<0.05).
And parameters of pulmonary function (FEV1, forced vital capacity(FVC), FEV1/FVC) were higher in variable group. Decline of FEV1 over 3 years was slower in stationary group during 3 years. (19 ± 179mL in stationary group, -76 ± 270mL in variable group).
Conclusions: FEV1 variability was associated with better initial symptom, quality of life, and pulmonary function. But it turned out to be associated with faster decline of FEV1.
OS-048 COPD
Relationship Between Lung Function and Chest X-Ray Findings in Koreans: A Population–Based Study
Sang Hoon Lee1, Joo Han Song1, Kyung Soo Chung1, Song Yee Kim1, Eun Young Kim1, Ji Ye Jung1, Young Ae Kang1, Moo Suk Park1, Se Kyu Kim1, Joon Chang1, Young Sam Kim1 Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseas- es, Yonsei University College of Medicine, Korea1
Background: Chronic obstructive pulmonary disease (COPD) is a major health prob- lem in many countries, and it is estimated to be the third common cause of death by 2020. However, there are few population-based studies to investigate the chest x-ray fi ndings in patients with COPD.
Methods: We investigated the relationship of lung function and chest x-ray fi ndings using Korea National Health and Nutrition Examination Survey data. A total of 45,811 subjects were enrolled from July 2008 to December 2012. 13,602 subjects (5,878 male and 7,724 female) who undertook chest x-ray and PFT were analyzed in this study.
Chest x-ray fi ndings were interpreted by one radiologist and four pulmonologists, and these readings were re-checked by six other doctors. Chest x-ray fi ndings are divided by 11 categories. PFT results are classifi ed as normal, obstructive, or restrictive pattern.
All data analysis was done by SAS 9.2.
Results: 10,342 (76.0%) subjects showed normal lung function; 1,776 (13.1%) obstructive pattern; 1,484 (10.9%) restrictive pattern. Inactive tuberculosis was the most common fi nding (7.9%) in this study. In subjects with airway obstruction, inactive tuberculosis (20.1%) was the most common fi nding and inactive other lung disease (6.3%) was the second. Like subject with obstructive lung pattern, inactive tuberculsis (11.3%) and inactive other lung dieseas (5.5%) were most common in subjects with restrictive lung function.
Conclusions: To the best of our knowledge, there were no studies to investigate the association of lung function and chest x-ray fi ndings using population based study.
In Korea, 20.1% of subjects with airway obstruction showed inactive tuberculosis on chest x-ray. Inactive tuberculosis and inactive other lung disease were most common chest x-ray fi ndings in both subjects with obstructive and restrictive lung function, but the proportion was different between two groups.
OS-049 COPD
The Impact of Static Hyperinfl ation in The Patients with Chronic Obstructive Pulmonary Disease
Joo Hun Park1, Tae Rim Shin2, Seungsoo Sheen1, Joon Beom Seo2, Kwang Ha Yoo2, Ji- Hyun Lee2, Tae-Hyung Kim2, Seong Yong Lim2, Ho Il Yoon2, Jae Seung Lee2, Yeon-Mok Oh2, Sang-Do Lee2
Ajou University Hospital, Korea1, KOLD Group, Korea2
Background: The progression of emphysema and airfl ow limitation in chronic ob- structive pulmonary disease (COPD) leads to static hyperinfl ation. However, few stud- ies have been conducted so far regarding the prognostic value of static hyperinfl ation marked by residual volume (RV)/ total lung capacity (TLC). Therefore we attempted to fi nd the independent factors related to static hyperinfl ation and to test the hypothe- sis that static hyperinfl ation is associated with the prognosis of COPD.
Methods: We analyzed 380 COPD patients of our Korean Obstructive Lung Disease (KOLD) cohort who were recruited from 16 hospitals in Korea from June 2005 to April 2012. Hyperinfl ated COPD was defi ned as 40% or more of RV/ TLC.
Results: Patients with hyperinfl ated COPD was older and male dominant, and had worse pulmonary function (represented by lower FEV1, FEV1/FVC, and FVC), higher emphysema index, and severer air-trapping, compared to non-hyperinflated COPD group (p<0.05). Multiple logistic regression analysis demonstrated that age (OR = 1.071), FEV1 (OR = 0.923), FEV1/FVC (OR = 0.948), and emphysema index (OR = 1.036) were independently associated with severe static hyperinflation ( RV/TLC =40%) (p<0.05). According to the severity of static hyperinfl ation, mean survival period was shorter (RV/TLC = 60% : 77.7 ± 4.6 months, 40 = RV/TLC <60 : 94.3 ± 1.9 months, RV/TLC < 40 % : 95.1 ± 1.8 months, p<0.05) and acute exacerbation was more fre- quent (p<0.05).
Conclusions: Old age, emphysema index, FEV1, and FEV1/FVC were independent fac- tors associated with hyperinfl ated COPD. The survival period was shorter according to the severity of static hyperinfl ation.
This study was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry for health and welfare (A102065).
