CHRONIC OBSTRUCTIVE LUNG DISEASE .2. RELATIONSHIP OF CLINICAL AND PHYSIOLOGIC FINDINGS TO SEVERITY OF AIRWAYS OBSTRUCTION

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Abstract
The severity of dyspnea and assessment of the severity of disease were found to correlate more closely with measurements of forced expiratory flow rates than with other variables in this study of 175 cases of chronic obstructive lung disease; and the 1 sec. forced expiratory volume (FEV1), calculated as a % of the predicted vital capacity, correlated slightly more closely with clinical assessments than did any other individual parameter, On this basis, the % FEV1 was utilized as an index of the severity of airways obstruction; and all clinical and physiologic findings were then correlated with this parameter. Typical clinical findings of emphysema were often absent in milder cases of chronic obstructive lung disease, which emphasizes the need for simple physiologic tests in the diagnosis of early cases. Most parameters tended to become more abnormal as expiratory slowing increased. However, age, family history, evidence of chronic bronchitis, rhonchi, and total lung capacity were not related to the severity of airways obstruction; and blood gas abnormalities, reduced diffusing capacity, evidence of cor pulmonale, and abnormalities on roentgeno-grams all correlated relatively poorly with expiratory slowing. These parameters may be related to factors in the disease other than the airways obstruction per se. It has been suggested that these parameters may be useful in distinguishing a more "bronchitic" from a more "emphysematous" type of obstructive lung disease.