Prevalence of chronic obstructive pulmonary disease (COPD) not diagnosed in a population with cardiovascular risk factors

• Published in: Medicina clínica (English ed.) 2018-11, Vol.151 (10), p.383-389
• Main Authors: Montserrat-Capdevila, Josep, Seminario, María Asunción, Godoy, Pere, Marsal, Josep Ramon, Ortega, Marta, Pujol, Jesús, Castañ, Maria Teresa, Alsedà, Miquel, Betriu, Àngels, Lecube, Albert, Portero, Manel, Purroy, Francisco, Valdivielso, José Manuel, Barbé, Ferran
• Format: Article
• Language: English
• Subjects: Chronic obstructive pulmonary disease (COPD); Enfermedad pulmonar obstructiva crónica; Epidemiology; Epidemiología; Factores de riesgo; Risk factors
• ISSN: 2387-0206; 2387-0206
• DOI: 10.1016/j.medcle.2018.09.006

The magnitude of undiagnosed COPD in our population with cardiovascular risk factors (CVRF) is unknown. The objective of this study was to estimate the prevalence of undiagnosed COPD and its specific characteristics in a population with CVRF. Study the prevalence of COPD in patients with CVRF. Spirometry was performed between 01/01/2015 and 12/31/2016 and the percentage of patients with COPD, who had not previously been diagnosed, was determined. Each patient's variables of interest were recorded; the records of patients who had spirometry showing COPD were checked to confirm whether a diagnosis had been recorded or not. The association of undiagnosed COPD with different independent variables was determined with adjusted odds ratio (aOR) by non-conditional logistic regression models. 2295 patients with CVRF were studied. The overall prevalence of COPD was 14.5%. An underdiagnosis of 73.3% was observed. Newly diagnosed COPD vs. undiagnosed COPD showed to be higher in women (74.1% vs. 36.0%; p=0.081), non-smokers (21.3% vs. 12.4%; p=0.577), mild cases (GOLD1) (42.6% vs. 32.4%, p=0.008) and cases with lower than average HbA1c (5.5% vs. 5.6%; p=0.008) and uric acid (5.1mg/dl vs. 5.6mg/dl; p=0.011). The variables associated with undiagnosed COPD were: women (aOR=1.27; 95% CI: 0.74–2.17; p=0.383); age (aOR=0.94; 95% CI: 0.87–0.99; p=0.018); smokers (smoker/non-smoker) (aOR=0.47; 95% CI: 0.22–1.01; p=0.054) and HbA1c (%) (aOR=0.45; 95% CI: 0.23–0.88; p=0.019). The under-diagnosis of COPD is very high. The contact patients aged between 50 and 65 years-old who have CVRF with their health system should be reassessed, and they need to ask for a spirometry. Se desconoce cuál es la magnitud de la enfermedad pulmonar obstructiva crónica (EPOC) no diagnosticada en nuestro medio en población con factores de riesgo cardiovascular (FRCV). El objetivo fue estimar la prevalencia de EPOC no diagnosticada y sus características en una población con FRCV. Estudio de prevalencia de EPOC en una población con FRCV seleccionada de forma aleatoria. Se les practicó una espirometría entre el 01/01/2015 y el 31/12/2016 y se determinó el porcentaje de pacientes con EPOC que no estaban diagnosticados previamente. Para cada paciente se registraron variables de interés y, en los enfermos con espirometría compatible con EPOC, si tenían o no registrado el diagnóstico en su historia clínica informatizada. La asociación de la EPOC no diagnosticada con las diferentes variables independientes se d