Characterisation and prognosis of undiagnosed chronic obstructive pulmonary disease patients at their first hospitalisation

Eva Balcells, Elena Gimeno-Santos, Jordi de Batlle, Maria Antonia Ramon, Esther Rodríguez, Marta Benet, Eva Farrero, Antoni Ferrer, Stefano Guerra, Jaume Ferrer, Jaume Sauleda, Joan A. Barberà, Àlvar Agustí, Robert Rodriguez-Roisin, Joaquim Gea, Josep M. Antó, Judith Garcia-Aymerich, Jósep M. Anto, Ignasi Serra, David Donaire-GonzalezADavidngel Gayete, Mauricio Orozco-Levi, Ivan Vollmer, Joan Albert Barberá, Federico P. Gomez, Carles Pare, Josep Roca, Xavier Freixa, Diego A. Rodriguez, Karina Portillo, Jordi Andreu, Esther Pallissa, Esther Rodriguez, Pere Casan, Rosa Guell, Ana Gimenez, Eduard Monso, Alicia Marin, Josep Morera, Joan Escarrabill, Bernat Togores, Juan Bautista Gáldiz, Lórena López, José Belda

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13 Citations (Scopus)

Abstract

© Balcells et al.; licensee BioMed Central. 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.
Original languageEnglish
Article number4
JournalBMC Pulmonary Medicine
Volume15
Issue number1
DOIs
Publication statusPublished - 17 Jan 2015

Keywords

  • Chronic obstructive
  • Cohort studies
  • Epidemiology
  • Health services
  • Hospitalisation
  • Pulmonary disease

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