Introduction: Performing lung function test in geriatric patients has never been an easy task. With well-established evidence indicating impaired small airway function and air trapping in patients with geriatric COPD, utilizing forced oscillation technique (FOT) as a supplementary tool may aid in the assessment of lung function in this population. Aims: To study the use of FOT in the assessment of airflow limitation and air trapping in geriatric COPD patients. Study design: A cross-sectional study in a public hospital in Hong Kong. ClinicalTrials.gov ID: NCT01553812. Methods: Geriatric patients who had spirometry-diagnosed COPD were recruited, with both FOT and plethysmography performed. “Resistance” and “reactance” FOT parameters were compared to plethysmography for the assessment of air trapping and airflow limitation. Results: In total, 158 COPD subjects with a mean age of 71.9±0.7 years and percentage of forced expiratory volume in 1 second of 53.4±1.7 L were recruited. FOT values had a good correlation ( r =0.4–0.7) to spirometric data. In general, X values (reactance) were better than R values (resistance), showing a higher correlation with spirometric data in airflow limitation ( r =0.07–0.49 vs 0.61–0.67), small airway ( r =0.05–0.48 vs 0.56–0.65), and lung volume ( r =0.12–0.29 vs 0.43–0.49). In addition, resonance frequency (Fres) and frequency dependence (FDep) could well identify the severe type (percentage of forced expiratory volume in 1 second <50%) of COPD with high sensitivity (0.76, 0.71) and specificity (0.72, 0.64) (area under the curve: 0.8 and 0.77, respectively). Moreover, X values could stratify different severities of air trapping, while R values could not. Conclusion: FOT may act as a simple and accurate tool in the assessment of severity of airflow limitation, small and central airway function, and air trapping in patients with geriatric COPD who have difficulties performing conventional lung function test. Moreover, reactance parameters were better than resistance parameters in correlation with air trapping.
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机译：简介：在老年患者中进行肺功能测试从来都不是一件容易的事。有确凿的证据表明老年COPD患者的小气道功能受损和空气滞留，使用强迫振荡技术（FOT）作为辅助工具可能有助于评估该人群的肺功能。目的：研究在老年人COPD患者中使用FOT评估气流受限和空气滞留的方法。研究设计：香港某公立医院的横断面研究。 ClinicalTrials.gov ID：NCT01553812。方法：招募经肺活量测定诊断为COPD的老年患者，同时进行FOT和体积描记法检查。将“电阻”和“反应” FOT参数与体积描记法进行比较，以评估空气滞留和气流限制。结果：总共招募了158名COPD受试者，平均年龄为71.9±0.7岁，强迫呼气量百分比为13.4秒（53.4±1.7 L）。 FOT值与肺活量测定数据具有良好的相关性（r = 0.4–0.7）。总的来说，X值（反应性）优于R值（抵抗性），显示出与肺活量数据在气流受限（r = 0.07-0.49 vs 0.61-0.67），小气道（r = 0.05-0.48 vs 0.56- 0.65）和肺活量（r = 0.12-0.29 vs 0.43-0.49）。此外，共振频率（Fres）和频率依赖性（FDep）可以很好地识别COPD的严重类型（1秒内呼气量百分比<50％），具有高灵敏度（0.76、0.71）和特异性（0.72、0.64） （曲线下的面积：分别为0.8和0.77）。此外，X值可以对不同严重程度的空气捕获进行分层，而R值则不能。结论：对于难以进行常规肺功能检查的老年COPD患者，FOT可能是评估气流受限，小和中枢气道功能以及空气滞留的严重程度的简单准确的工具。此外，与空气滞留相关，电抗参数优于电阻参数。
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