Characterisation and prognosis of undiagnosed chronic obstructive pulmonary disease patients at their first hospitalisation
Author
Publication date
2015-01Abstract
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.
Document Type
Article
Document version
Published version
Language
English
Keywords
Pulmons -- Malalties
Pulmons -- Malalties obstructives
Hospitalització
Estudi de cohort
Epidemiologia
Serveis sanitaris
Pages
9 p.
Publisher
BioMed Central
Is part of
BMC Pulmonary Medicine, 2015, 15: 4
Grant agreement number
info:eu-repo/grantAgreement/MINECO/ISCIII/FIS PI020541
info:eu-repo/grantAgreement/SUR del DEC/AATRM/035/20/02
info:eu-repo/grantAgreement/MINECO/ISCIII/PI052486
info:eu-repo/grantAgreement/MINECO/ISCIII/PI052302
info:eu-repo/grantAgreement/MINECO/ISCIII/PI060684
info:eu-repo/grantAgreement/Fundació la Marató de TV3/041110
This item appears in the following Collection(s)
Rights
© L'autor/a
Except where otherwise noted, this item's license is described as http://creativecommons.org/licenses/by/4.0/