Source: Annual Congress 2002 - Asthma - Therapy and management -3
Disease area: Airway diseases

Abstract

Acoustic signals are generated by the lungs. It has been described that pulmonary sound data can correctly classify FEV1-values by using computerised spectral sound analysis. In this study, we wanted to determine the relationship of physicians' estimation of the airway obstruction by auscultation and the measured FEV1%predicted values.
112 patients admitted to the medical emergency room (ER) unit were entered into the study. After taking their history, all patients were auscultated by an Internal Medicine registrar and 60 patients also by a senior registrar. The degree of airway obstruction had to be estimated (0= no, 1= mild, 2= moderate and 3= severe obstructed). Then a spirometry was performed in all patients.
28 patients had a normal lung function and 84 ones an airway obstruction:

Grade of obstruction	N	age	FEV1%pred	FVC%pred	FEV1%FVC
No	28	48.9(20-81)	94.9 (±]9.5)	93.6(±]12.8)	85.1 (±]6.8)
Mild	6	54.8(22-88)	74.5 (±]3.5)	99.2 (±]17.7)	61.7 (±]9)
Moderate	22	58 (24-83)	58.1 (±]5.7)	76.1 (±]14.2)	62.4 (±]6)
Severe	56	62.7(16-89)	31.1 (±]10)	50.4 (±]23.9)	51.4 (±]14.4)

There was a significant correlation between the FEV1% predicted and the auscultation based estimation of airway obstruction in registrars (Spearman¢ rho=0.72; p<0.01) as well as in senior registrars (rho=0.62; p<0.01). Internal Medicine registrars reached a sensitivity/specificity to detect airway obstruction of 71.6% / 74.4% and senior registrars one of 73.1% / 89.5%.
We conclude that under ER conditions physicians estimate accurately the degree of airway obstruction by auscultation.

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J. D. Leuppi, I. Meisinger-Wildeisen, G. Koch, T. Dieterle, B. Martina, M. Tamm, A. P. Perruchoud, B. Leimenstoll (Basel, Switzerland). Estimation of airway obstruction by auscultation under emergency room condition. Eur Respir J 2002; 20: Suppl. 38, 443

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