Prevalence, risk factors, and clinical implications of failed spirometry in adults: Results from NHANES 2007-2012.

Abstract

Background and research question: Some participants inevitably fail spirometry testing and we aimed to assess the prevalence, risk factors, chronic respiratory symptoms, health status, and all-cause mortality outcomes associated with failed spirometry.

Methods: Using NHANES 2007-2012 data, we categorized participants into three groups: those with failed spirometry (FS-participants), those with qualified spirometry without COPD (QS-non-COPD), and those with qualified spirometry and COPD (QS-COPD). We assessed the prevalence and risk factors associated with FS-participants and compared clinical implications among the three groups.

Results: The prevalence of FS-participants was 4.8%. Key risk factors included older age, being male, non-Hispanic Black ethnicity, lower socioeconomic status, self-reported emphysema, and increased frailty. After adjustment, FS-participants had higher odds of shortness of breath, wheezing, and dry cough at night (all P values < 0.05). They also faced a greater risk of all-cause mortality (HR: 1.51, 95% CI: 1.22 to 1.86; p < 0.001) compared to the QS-non-COPD group, a risk similar to that of the QS-COPD group (HR: 1.05, 95% CI: 0.82 to 1.27; p = 0.675).

Conclusion: Failed spirometry is common among adults and correlates with increased respiratory symptoms and higher all-cause mortality risk, indicating the need for targeted attention.