Prevalence and nature of lung function abnormalities among Indigenous Australians referred to specialist respiratory outreach clinics in the Northern Territory

Jonathon Schubert, Anuk Kruavit, Sumit Mehra, Sanjiwika Wasgewatta, Anne Chang, Subash Heraganhally

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background and objective: Poor lung function is a predictor of future all‐cause mortality. In Australia, respiratory diseases are particularly prevalent among the Indigenous population, especially in remote communities. However, there are little published pulmonary function tests (PFT) data of remote‐based adult Indigenous patients. We aimed to evaluate the severity of airflow obstruction and other PFT abnormalities of adults referred to specialist respiratory clinics in remote Indigenous communities.

Methods: Retrospective analysis of PFTs [pre‐ and post‐bronchodilator spirometry, total lung capacity (TLC) and diffusing capacity to carbon monoxide (DLCO)] of Indigenous patients collected during specialist respiratory clinics in remote Northern Territory (NT) Indigenous communities (Australia) between 2013‐2015. The National Health and Nutrition Examination Survey (NHANES) III without ethnic correction was used as the reference.

Results: Of the 357 patients, 150 had acceptable spirometry and 71 had acceptable DLCO and TLC studies. Despite the relatively young age (mean=49 years, SD=12.9) their lung function was generally low; mean % predicted values were FEV1=55%(SD=20.5%), FVC=61%(SD=15.6%), DLCO=64.0%(SD=19.7%), TLC=70.1%(SD=18.2%). Mean FEV1/FVC ratio was preserved (0.71, SD=0.16). Post‐bronchodilator airflow obstruction (FEV1/FVC<0.7) was found in 37% of patients, where a large proportion (67%) demonstrated at least severe airflow obstruction with a mean FEV1 of 41% predicted.

Conclusion: In this first study of PFT findings of Indigenous adults from a remote‐based clinical service, we found a high rate of at least moderate airflow limitation and low FVC along with preserved FEV1/FVC ratio. Increased awareness and screening for reduced lung function needs to be considered in this population.
Original languageEnglish
Pages (from-to)217-224
Number of pages8
JournalInternal Medicine Journal
Volume49
Issue number2
Early online date21 Sep 2018
DOIs
Publication statusPublished - Feb 2019

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Northern Territory
Total Lung Capacity
Respiratory Function Tests
Lung
Spirometry
Nutrition Surveys
Carbon Monoxide
Population Groups
Mortality
Population

Cite this

Schubert, Jonathon ; Kruavit, Anuk ; Mehra, Sumit ; Wasgewatta, Sanjiwika ; Chang, Anne ; Heraganhally, Subash. / Prevalence and nature of lung function abnormalities among Indigenous Australians referred to specialist respiratory outreach clinics in the Northern Territory. In: Internal Medicine Journal. 2019 ; Vol. 49, No. 2. pp. 217-224.
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abstract = "Background and objective: Poor lung function is a predictor of future all‐cause mortality. In Australia, respiratory diseases are particularly prevalent among the Indigenous population, especially in remote communities. However, there are little published pulmonary function tests (PFT) data of remote‐based adult Indigenous patients. We aimed to evaluate the severity of airflow obstruction and other PFT abnormalities of adults referred to specialist respiratory clinics in remote Indigenous communities.Methods: Retrospective analysis of PFTs [pre‐ and post‐bronchodilator spirometry, total lung capacity (TLC) and diffusing capacity to carbon monoxide (DLCO)] of Indigenous patients collected during specialist respiratory clinics in remote Northern Territory (NT) Indigenous communities (Australia) between 2013‐2015. The National Health and Nutrition Examination Survey (NHANES) III without ethnic correction was used as the reference.Results: Of the 357 patients, 150 had acceptable spirometry and 71 had acceptable DLCO and TLC studies. Despite the relatively young age (mean=49 years, SD=12.9) their lung function was generally low; mean {\%} predicted values were FEV1=55{\%}(SD=20.5{\%}), FVC=61{\%}(SD=15.6{\%}), DLCO=64.0{\%}(SD=19.7{\%}), TLC=70.1{\%}(SD=18.2{\%}). Mean FEV1/FVC ratio was preserved (0.71, SD=0.16). Post‐bronchodilator airflow obstruction (FEV1/FVC<0.7) was found in 37{\%} of patients, where a large proportion (67{\%}) demonstrated at least severe airflow obstruction with a mean FEV1 of 41{\%} predicted.Conclusion: In this first study of PFT findings of Indigenous adults from a remote‐based clinical service, we found a high rate of at least moderate airflow limitation and low FVC along with preserved FEV1/FVC ratio. Increased awareness and screening for reduced lung function needs to be considered in this population.",
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Prevalence and nature of lung function abnormalities among Indigenous Australians referred to specialist respiratory outreach clinics in the Northern Territory. / Schubert, Jonathon ; Kruavit, Anuk ; Mehra, Sumit ; Wasgewatta, Sanjiwika ; Chang, Anne; Heraganhally, Subash.

In: Internal Medicine Journal, Vol. 49, No. 2, 02.2019, p. 217-224.

Research output: Contribution to journalArticleResearchpeer-review

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AB - Background and objective: Poor lung function is a predictor of future all‐cause mortality. In Australia, respiratory diseases are particularly prevalent among the Indigenous population, especially in remote communities. However, there are little published pulmonary function tests (PFT) data of remote‐based adult Indigenous patients. We aimed to evaluate the severity of airflow obstruction and other PFT abnormalities of adults referred to specialist respiratory clinics in remote Indigenous communities.Methods: Retrospective analysis of PFTs [pre‐ and post‐bronchodilator spirometry, total lung capacity (TLC) and diffusing capacity to carbon monoxide (DLCO)] of Indigenous patients collected during specialist respiratory clinics in remote Northern Territory (NT) Indigenous communities (Australia) between 2013‐2015. The National Health and Nutrition Examination Survey (NHANES) III without ethnic correction was used as the reference.Results: Of the 357 patients, 150 had acceptable spirometry and 71 had acceptable DLCO and TLC studies. Despite the relatively young age (mean=49 years, SD=12.9) their lung function was generally low; mean % predicted values were FEV1=55%(SD=20.5%), FVC=61%(SD=15.6%), DLCO=64.0%(SD=19.7%), TLC=70.1%(SD=18.2%). Mean FEV1/FVC ratio was preserved (0.71, SD=0.16). Post‐bronchodilator airflow obstruction (FEV1/FVC<0.7) was found in 37% of patients, where a large proportion (67%) demonstrated at least severe airflow obstruction with a mean FEV1 of 41% predicted.Conclusion: In this first study of PFT findings of Indigenous adults from a remote‐based clinical service, we found a high rate of at least moderate airflow limitation and low FVC along with preserved FEV1/FVC ratio. Increased awareness and screening for reduced lung function needs to be considered in this population.

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