Characterisation and prognosis of undiagnosed chronic obstructive pulmonary disease patients at their first hospitalisation

BMC Pulmonary Medicine

Judith Garcia-Aymerich⁴  Josep M Antó⁴  Joaquim Gea⁷  Robert Rodriguez-Roisin⁶  Àlvar Agustí⁶  Joan A Barberà⁶  Jaume Sauleda⁶  Jaume Ferrer⁵  Stefano Guerra⁴  Antoni Ferrer⁷  Eva Farrero¹  Marta Benet⁴  Esther Rodríguez⁵  Maria Antonia Ramon⁵  Jordi de Batlle³  Elena Gimeno-Santos²  Eva Balcells⁷ 

[1] IDIBELL (Institut d’Investigació Biomèdica de Bellvitge), Gran Via de L’Hospitalet 199, 08908 Hospitalet de Llobregat, Spain;FCS Blanquerna, Research in Physiotherapy Group (GReFis), Universitat Ramon Llull, Padilla 326 08025 Barcelona, Spain;Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France;CIBER Epidemiología y Salud Pública (CIBERESP), Doctor Aiguader 88, 08003 Barcelona, Spain;Servei de Pneumologia, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain;CIBER de Enfermedades Respiratorias (CIBERES), Recinte Hospital Joan March, Carretera Soller km 12, 07110 Bunyola, Spain;Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain

关键词: Health services;    Epidemiology;    Cohort studies;    Hospitalisation;    Chronic obstructive;    Pulmonary disease;   

Others  :  1090459
DOI  :  10.1186/1471-2466-15-4

 received in 2015-01-04, accepted in 2015-01-08,  发布年份 2015

【 摘 要 】

Background

Under-diagnosis of COPD is an important unmet medical need. We investigated the characteristics and prognosis of hospitalised patients with undiagnosed COPD.

Methods

The PAC-COPD cohort included 342 COPD patients hospitalised for the first time for an exacerbation of COPD (2004–2006). Patients were extensively characterised using sociodemographic, clinical and functional variables, and the cohort was followed-up through 2008. We defined “undiagnosed COPD” by the absence of any self-reported respiratory disease and regular use of any pharmacological respiratory treatment.

Results

Undiagnosed COPD was present in 34% of patients. They were younger (mean age 66 vs. 68 years, p = 0.03), reported fewer symptoms (mMRC dyspnoea score, 2.1 vs. 2.6, p < 0.01), and had a better health status (SGRQ total score, 29 vs. 40, p < 0.01), milder airflow limitation (FEV₁% ref., 59% vs. 49%, p < 0.01), and fewer comorbidities (two or more, 40% vs. 56%, p < 0.01) when compared with patients with an established COPD diagnosis. Three months after hospital discharge, 16% of the undiagnosed COPD patients had stopped smoking (vs. 5%, p = 0.019). During follow-up, annual hospitalisation rates were lower in undiagnosed COPD patients (0.14 vs. 0.25, p < 0.01); however, this difference disappeared after adjustment for severity. Mortality was similar in both groups.

Conclusions

Undiagnosed COPD patients have less severe disease and lower risk of re-hospitalisation when compared with hospitalised patients with known COPD.

【 授权许可】

   
2015 Balcells et al.; licensee BioMed Central.

【 图 表 】

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