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Characterisation and prognosis of undiagnosed chronic obstructive pulmonary disease patients at their first hospitalisation
Balcells, Eva Gimeno-Santos, Elena de Batlle, Jordi Ramon, Maria Antonia Rodríguez, Esther Benet, Marta Farrero, Eva Ferrer, Antoni Guerra, Stefano Ferrer, Jaume
Balcells, Eva
Gimeno-Santos, Elena
de Batlle, Jordi
Ramon, Maria Antonia
Rodríguez, Esther
Benet, Marta
Farrero, Eva
Ferrer, Antoni
Guerra, Stefano
Ferrer, Jaume
Author
Balcells, Eva
Gimeno-Santos, Elena
de Batlle, Jordi
Ramon, Maria Antonia
Rodríguez, Esther
Benet, Marta
Farrero, Eva
Ferrer, Antoni
Guerra, Stefano
Ferrer, Jaume
Sauleda, Jaume
Barberà, Joan A.
Agustí, Àlvar
Rodriguez-Roisin, Robert
Gea, Joaquim
Antó, Josep M.
Garcia-Aymerich, Judith
the, P. A. C. Copd Study Group
Donaire Gonzalez, David
Gimeno-Santos, Elena
de Batlle, Jordi
Ramon, Maria Antonia
Rodríguez, Esther
Benet, Marta
Farrero, Eva
Ferrer, Antoni
Guerra, Stefano
Ferrer, Jaume
Sauleda, Jaume
Barberà, Joan A.
Agustí, Àlvar
Rodriguez-Roisin, Robert
Gea, Joaquim
Antó, Josep M.
Garcia-Aymerich, Judith
the, P. A. C. Copd Study Group
Donaire Gonzalez, David
Abstract
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.
Keywords
pulmonary disease, chronic obstructive, hospitalisation, cohort studies, epidemiology, health services
Date
2015
Type
Journal article
Journal
BMC Pulmonary Medicine
Book
Volume
15
Issue
1
Page Range
1-9
Article Number
Article 4
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY 4.0
File Access
Open