Preoperative spirometry in high-risk patients (≥40 years, ≥10 pack-years smoking) newly identified COPD in 16.8% of those tested, accounting for approximately 40% of all COPD cases in the cohort.
Observational (n=5,367)
No
Does preoperative spirometry in high-risk patients improve the early detection of undiagnosed COPD?
Targeted preoperative spirometry in high-risk patients (age ≥40, ≥10 pack-years smoking) effectively identifies a substantial proportion of previously undiagnosed COPD cases.
Abstract Rationale Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. However, studies indicate that 60-80% of individuals with COPD remain undiagnosed. Early detection among high-risk populations is essential and can significantly improve clinical outcomes. This study aimed to identify previously undiagnosed COPD cases through preoperative assessments conducted as part of a quality improvement program. Methods This program was conducted at Taichung Veterans General Hospital between October 2023 and September 2025. Patients referred for preoperative respiratory assessment were included. Individuals aged 40 years or older with a smoking history of at least 10 pack-years were classified as high risk for COPD. A diagnosis of COPD was established in patients with a post-bronchodilator FEV1/FVC ratio of less than 70% on spirometry. Results Of the 5,367 patients referred for preoperative assessment, 666 (12.4%) met the criteria for being at high risk of COPD, and 69 of them had a known diagnosis of COPD (FEV1/FVC 70%) within the previous year. Among the remaining 597 high-risk patients, 303 (50.8%) successfully completed spirometry, and 51 (16.8%) were newly identified as having COPD (FEV1/FVC 70%). In total, 120 patients were found to have COPD, representing a prevalence of 2.2% among all assessed patients. The characteristics, including age, sex, smoking history, and spirometry findings, were comparable between newly identified and previously diagnosed COPD patients. Conclusion A substantial proportion of COPD cases in this cohort were previously undiagnosed, with up to 40% newly identified through this program. We recommend performing spirometry in patients with respiratory symptoms, older age, or a significant smoking history to facilitate early detection of COPD. Early identification and timely intervention may contribute to improved clinical outcomes. This abstract is funded by: None
Lee et al. (2026) conducted an observational in Chronic obstructive pulmonary disease (COPD) (n=5,367). Preoperative spirometry assessment was evaluated on Newly identified COPD (post-bronchodilator FEV1/FVC < 70%) among high-risk patients completing spirometry. Preoperative spirometry in high-risk patients (≥40 years, ≥10 pack-years smoking) newly identified COPD in 16.8% of those tested, accounting for approximately 40% of all COPD cases in the cohort.
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