A Retrospective Cohort Study on the Prevalence and Risk Factors of Preserved Ratio Impaired Spirometry (PRISm) at Pattaya Bhattamakun Hospital
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Abstract
Background: Preserved ratio impaired spirometry (PRISm) is defined by a reduced FEV₁ with a preserved FEV₁/FVC ratio and FVC. In practice, this pattern is often interpreted as normal, despite underlying abnormalities. Previous studies have suggested that PRISm may be associated with adverse outcomes, but its prevalence and clinical significance are still not clearly established. This study aimed to determine the prevalence of PRISm and explore its associated risk factors and clinical outcomes at Pattaya Bhattamakun Hospital.
Methods: A retrospective cross-sectional study was conducted including 710 patients who underwent pulmonary function testing between January 2015 and April 2026. PRISm was defined using either lower limit of normal (LLN) or fixed-ratio criteria. Data on demographics, comorbidities, hospitalizations, and mortality were collected from ICD-10 records. Logistic regression was used to identify risk factors, and correlations with outcomes were assessed using Spearman’s rank test.
Results: The prevalence of PRISm was 9.0% (95% CI: 6.9–11.1). When classified separately, prevalence was 3.2% by LLN and 8.9% by fixed-ratio criteria. Female sex, smoking, and obesity were independently associated with PRISm. There was no significant association with all-cause mortality, but PRISm was associated with increased hospitalizations, particularly those related to airway disease.
Conclusions: PRISm was not uncommon in this population and was associated with a higher risk of hospitalization. These findings suggest that PRISm should not be overlooked in clinical practice. Further studies are needed to better understand its long-term outcomes and management.
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