Relationship between respiratory symptoms and FEV1 in COPD and Bronchial asthma in RIMS Medical College & Hospital, Kadapa, Andhra Pradesh, India

Background : Chronic obstructive pulmonary disease (COPD) and Bronchial Asthma are the major causes of pulmonary disability. Both are chronic inflammatory lung diseases characterized by airway obstruction. Chronic Obstructive Pulmonary Disease (COPD), is the fourth leading cause of death in the world, represents an important public health challenge that is both preventable and treatable. COPD is a major cause of chronic morbidity and mortality throughout the world. Asthma is a common, chronic respiratory disease affecting 1–18% of the population in different countries. Asthma is characterized by variable symptoms and expiratory airflow limitation. COPD and Bronchial asthma are diagnosed based on clinical criteria and spirometry. Dyspnea is one of the major symptoms that impact the quality of life. FEV1 is an objective index and the level of dyspnea is a subjective index in assessing patients with obstructive lung diseases. Recently there has been an increased emphasis on objective measurements of pulmonary function in the management of COPD and Bronchial asthma. There is a variable relationship between clinical parameters and pulmonary function. (7) The most commonly used way to express disease severity is by assessing the FEV1 as a measure for airway obstruction. The FEV1 is a reproducible and objective measurement. Serial measurements of FEV1 may provide evidence of disease progression. The purpose of this study is to compare clinical symptoms with the actual values of FEV1 in patients with COPD and Bronchial asthma. This study also determines the best clinical predictors of COPD and Bronchial asthma to define the incremental changes in the ability to diagnose disease severity, when the symptoms and FEV1 are combined together. This would help in optimizing the management of patients COPD and Bronchial asthma and to decrease the disease progression. Material and methods: Out of 155 adults studied 96 patients were included. 47 out of 96 were COPD patients and the rest were Bronchial asthma patients. Sample was taken from patients who attended the outpatient department or admitted in the wards of Rajive Gandhi Institute Of Medical Sciences Hospital & College Kadapa. From July 2017 to June 2018.Patients were examined and data collected on a pretested proforma.STUDY TYPE: Cross sectional study of patients with diagnosis of COPD and Bronchial asthma. Conclusion: In conclusion, the patients in both Bronchial asthma and COPD subgroups, the statistical significance of correlating clinical symptoms with objective measurement of airway obstruction (by FEV1) is not exact. Therefore both groups of patients are better managed with a combination of objective assessment of pulmonary function and symptom scores. In Bronchial asthma patients, severity of symptoms does not statistically correlate with FEV1 measurements. Subjective wheeze is the individual symptom best approaching correlation with FEV1. COPD patients have better inverse correlation between symptoms and FEV1 though not achieving statistical significance in present study. mMRC grade of dyspnea is best individual symptom in this group of individuals, correlating with measured FEV1 values.Present study emphasizes the importance of using objective assessment of lung function in both Bronchial asthma and COPD patients prior to implementation of medical treatment strategies.