Bronchodilator reversibility among patients with asthma presenting to tertiary care hospitals in Trivandrum, India

Introduction: Demonstration of post-bronchodilator reversibility is considered as an important tool for the diagnosis of Asthma, however this is not demonstrable in all patients. Aims and Objectives: To determine the proportion of patients with Asthma presenting to tertiary care hospital in Trivandrum, South India who show post-bronchodilator reversibility on spirometry and to determine the factors associated with reversibility Methods: Consecutive patients with clinician diagnosed asthma (by a senior pulmonologist, based on GINA guidelines) underwent spirometry as part of their diagnostic work-up at the time of their presentation in two tertiary care hospitals. Pre- and post bronchodilator spirometry were done by an expert technician. Reversibility was defined as increase in FEV1 by 200ml and 12% Results: 200 consecutive patients with Asthma were recruited. Mean age of the patients was 41.5 years (SD - 18.2). 59.5% of the patients were femaies. The proportion of patients with reversibility was 47% (95%CI-40%,54%). The factors associated with reversibility were low age( 0.05). Conclusion: While developing local guidelines for diagnosis of Asthma, the fact that reversibility can be demonstrated only less than 50% of patients must be considered, otherwise a significant proportion of cases with Asthma may be missed or misdiagnosed as COPD.