Safety of pulmonary function testing: data from 20 years

Thorax. 2018 Apr;73(4):385-387. doi: 10.1136/thoraxjnl-2017-210246. Epub 2017 Jun 29.

Abstract

Background: Pulmonary function testing (PFT) is a key investigation in the evaluation of individuals with respiratory symptoms; however, the safety of routine and specialised PFT testing has not been reported in a large data set. Using patient safety incident (PSI) records, we aimed to assess risk of PFT and to characterise these events and any associated risk factors.

Methods: In this single-centre audit, demographics and PSI data were collected and categorised for PFT performed between 1996 and 2016 and subdivided into cardiopulmonary or non-cardiopulmonary events. The severity of each PSI was rated using the NHS National Patient Safety Agency and any hospital admission reported.

Results: There were 119 PSIs reported from 186 000 PFT; that is, 0.6 PSIs per 1000 tests. Cardiopulmonary PSIs were 3.3 times more likely to occur than non-cardiopulmonary (95% CI 2.17 to 5.12). Syncope was the most frequently occurring cardiopulmonary PSI. Cardiopulmonary exercise testing was associated with 2 PSIs per 1000 tests. PSIs necessitating hospital admission and/or emergency department attendance occurred approximately once every 10 000 tests and there was no PFT-associated mortality.

Conclusion: Routine and specialised PFT is safe for patients, in the context of established screening preparticipation guidelines. In the event of a PSI, these are likely to be low risk of harm. Our findings highlight the most common PSIs encountered during PFT to facilitate risk reduction.

Keywords: cardiopulmonary; pulmonary; safety; spirometry; testing.

Publication types

  • Letter

MeSH terms

  • Adult
  • Aged
  • Bronchial Spasm / epidemiology*
  • Bronchial Spasm / etiology
  • Dizziness / epidemiology*
  • Dizziness / etiology
  • Emergency Service, Hospital
  • Female
  • Humans
  • Male
  • Medical Audit
  • Middle Aged
  • Patient Safety*
  • Respiratory Function Tests / adverse effects
  • Respiratory Function Tests / methods
  • Respiratory Function Tests / statistics & numerical data*
  • Syncope / epidemiology*
  • Syncope / etiology
  • United Kingdom / epidemiology