COPD: an underdiagnosed disease at hospital environment

Wien Klin Wochenschr. 2014 Feb;126(3-4):73-8. doi: 10.1007/s00508-013-0458-4. Epub 2013 Nov 19.

Abstract

Background and aim: Chronic obstructive pulmonary disease (COPD) is a serious disease with morbidity and mortality due to delayed diagnosis until significant symptoms arise. We aimed to assess the utility of spirometry and COPD Assessment Test (CAT) in detecting undiagnosed COPD patients in a localized area.

Material and methods: People who came to the hospital for patient visit or examination with a smoking history of > 10 pack-years (> 40 years old), and with no known chest disease were invited to study. The participants completed a questionnaire and performed spirometry. Spirometry was performed according to ATS/ERS Task Force on spirometry. COPD was defined as according to the Global Initiative for Chronic Obstructive Lung Disease guidelines.

Results: There were 800 subjects screened, and 648, capable of performing spirometry, were included to the study. The mean age was 48.3 ± 9.0 and 38 % of the study population was male. Post-bronchodilator FEV1/FVC ratio was lower than 0.70 in 17 % of the subjects. Median (25-75 percentiles) total CAT scores and among the questions of CAT; cough, phlegm, chest tightness and breathlessness scores for COPD and non-COPD subjects were; 15(9-22) vs 12(6-18) (p = .004), 2(1-3) vs 1(0-2) (p < .001), 2(0-3) vs 1(0-3) (p = .004), 3(1-4) vs 2(0-3) (p > .001), 4(3-5) vs 3(2-4) (p = .001), respectively. Symptom prevalence was as follows: exertional dyspnea 91 %, dyspnea 80.9 %, cough 56.3 % and phlegm 58.3 % in COPD.

Conclusion: Our study showed that spirometric screening together with the CAT questionnaire may improve the awareness of disease and may determine undiagnosed patients.

MeSH terms

  • Comorbidity
  • Cough / epidemiology*
  • Dyspnea / epidemiology*
  • Educational Status
  • Employment
  • False Negative Reactions
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Mass Screening / statistics & numerical data
  • Middle Aged
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / diagnosis*
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Reproducibility of Results
  • Risk Factors
  • Sensitivity and Specificity
  • Smoking / epidemiology*
  • Spirometry / statistics & numerical data*
  • Surveys and Questionnaires
  • Turkey / epidemiology