COPD: an underdiagnosed disease at hospital environment

Kart, Levent; Akkoyunlu, Muhammed Emin; Bayram, Mehmet; Yakar, Fatih; Özçelik, Hatice Kutbay; Karaköse, Fatmanur; Sezer, Murat

doi:10.1007/s00508-013-0458-4

Cited by 14 publications

(19 citation statements)

References 21 publications

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“…These studies have found between 25 and 34% of the study populations to have undiagnosed COPD. [9,16] This is not consistent with the findings of this study where a considerably smaller proportion the examined patients were diagnosed with COPD. There are several possible explanations of this.…”

Section: Discussioncontrasting

confidence: 89%

“…There are several possible explanations of this. In the study by Kart et al [16] examining outpatients and patients hospitalized for elective treatment, a considerably larger proportion of the study population were able to participate in spirometry; in the study by Nielsen et al [9] all inpatients were examined, and in neither of these studies the study populations were followed up in stable state. In fact, in this study a larger proportion of the study population had airflow obstruction at the initial examination than in the above-mentioned studies.…”

Section: Discussionmentioning

confidence: 99%

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Undiagnosed chronic obstructive pulmonary disease in patients admitted to an acute assessment unit

Eikhof

Olsen

Wrengler

et al. 2017

European Clinical Respiratory Journal

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Introduction: Chronic obstructive pulmonary disease (COPD) is very prevalent worldwide, yet underdiagnosed. Aim: This study investigates feasibility of performing spirometry in patients in need of acute hospital admission as well as the prevalence of undiagnosed COPD in the same cohort. Methods: During a two-week period, all patients admitted to three large acute assessment units were evaluated. Patients ≥ 18 years, able to perform spirometry, with no surgery to the thorax or abdomen within the last weeks and no known COPD was included. Patients with FEV1/FEV6 ≤ 0.7 or FEV1 < 80% or FEV6 < 80% were offered follow-up visit after 6 weeks. Results: Of the 1145 admitted patients, 46% were eligible: 28% of those had an abnormal spirometry. The offered follow-up visit was attended by 51% and in this group 17% were diagnosed with lung disease. COPD was the most prevalent diagnosis (73%), and 2/3 was in GOLD group A. In total, 75% of the patients with airflow obstruction at the initial examination remained obstructive. Conclusion: Performing spirometry in patients in need of acute hospital admission is feasible, abnormal findings are common, and COPD is the most prevalent diagnosis.

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Section: Discussioncontrasting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Undiagnosed chronic obstructive pulmonary disease in patients admitted to an acute assessment unit

Eikhof

Olsen

Wrengler

et al. 2017

European Clinical Respiratory Journal

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“…Even when it is there, professionals in LMIC are often not being trained properly on how to use spirometers or interpret spirometry results. There is concern that COPD burden has been underestimated, owing to over-reliance on doctor' s diagnosis, with many diagnoses not being based on spirometry and international diagnostic guidelines [20]. The lack of routine COPD data collation and effective health information management system in many LMIC also implies that these settings could have been grossly underrepresented in global burden of COPD estimates [11].…”

mentioning

confidence: 99%

Global and regional estimates of COPD prevalence: Systematic review and meta–analysis

Rudan¹,

Chua²,

Lee³

et al. 2015

Journal of Global Health

937

593

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“…COPD was diagnosed using a spirometry reference test rather than the mini-spirometry employed in most similar studies. 14,15 No COPD-asthma overlap was to be feared because asthma cases had no evidence of obstructive spirometry. Finally, we used a sound statistical methodology based on bootstrap resampling to select the best subset of independent covariates and to adjust for overfitting.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11] The COPD Assessment Test (CAT) was initially developed and validated for routinely assessing and monitoring COPD patients. 12,13 It was later used to help screen for COPD in both smokers, 14,15 and the general population. 16,17 Subjects who the CAT questionnaire indicated were at risk then underwent diagnostic spirometry and appropriate medical management, if necessary, before any severe symptoms developed.…”

Section: Introductionmentioning

confidence: 99%

Use of the COPD Assessment Test (CAT) to screen for COPD in dairy farmers: AIRBAg study

Šimon

Metten

Chapron

et al. 2020

Clinical Respiratory J

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Objectives People at risk of chronic obstructive pulmonary disease (COPD) can benefit from appropriate medical management before severe symptoms appear. This study assesses the value of the COPD Assessment Test (CAT) questionnaire for screening dairy farmers, who tend to be slow or reluctant to seek health care. Methods During the time period 2012‐2017, 2089 randomly selected dairy farmers in Brittany (France) were invited to complete self‐administered questionnaires (including the CAT) and to undergo an occupational health check‐up using an electronic mini‐spirometer and conventional spirometry. Those showing symptoms suggestive of COPD and/or a ratio FEV1/FEV6 < 80% were sent to a pulmonologist for a further check‐up, including spirometry with a reversibility test. Multivariate logistic models based on CAT scores and socio‐demographic or work‐related factors were developed to predict COPD. Results The 1231 farmers who underwent the occupational health check‐up included 1203 who met the inclusion/exclusion criteria. Pulmonologist identified 16 (1.3%) cases of COPD. A multivariate logistic regression model (covariates: CAT sum score, on‐farm time, BMI, smoking status, free‐stall mulching) provided an area under the receiver‐operating characteristic curve (AUC) of 0.87 (95% CI: 0.75‐0.98). Using a cut‐off of 0.007 gave a sensitivity of 93.8% and a specificity of 62.4%. Another model that included CAT breathlessness and the same covariates performed marginally better (AUC = 0.88, 95% CI: 0.77‐0.98). Conclusion Our predictive models can both benefit dairy farmers by providing early diagnosis and management of their COPD and avoid unnecessary, costly spirometry during the screening process.

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COPD: an underdiagnosed disease at hospital environment

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

Cited by 14 publications

References 21 publications

Undiagnosed chronic obstructive pulmonary disease in patients admitted to an acute assessment unit

Undiagnosed chronic obstructive pulmonary disease in patients admitted to an acute assessment unit

Global and regional estimates of COPD prevalence: Systematic review and meta–analysis

Use of the COPD Assessment Test (CAT) to screen for COPD in dairy farmers: AIRBAg study

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