COPD: an underdiagnosed disease at hospital environment

• Published in: Wiener Klinische Wochenschrift 2014-02, Vol.126 (3-4), p.73-78
• Main Authors: Kart, Levent, Akkoyunlu, Muhammed Emin, Bayram, Mehmet, Yakar, Fatih, Kutbay Özçelik, Hatice, Karaköse, Fatmanur, Sezer, Murat
• Format: Article
• Language: English
• Subjects: Comorbidity; Cough - epidemiology; Dyspnea - epidemiology; Educational Status; Employment; Endocrinology; False Negative Reactions; Gastroenterology; Hospitalization - statistics & numerical data; Humans; Internal Medicine; Male; Mass Screening - statistics & numerical data; Medicine; Medicine & Public Health; Middle Aged; Original Article; Pneumology/Respiratory System; 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
• ISSN: 0043-5325; 1613-7671
• DOI: 10.1007/s00508-013-0458-4

Summary 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), 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.