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Colegio de Medicina Interna de México.

2014, Number 3

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Med Int Mex 2014; 30 (3)

Efficacy of Clinical Criteria and Risk Factors in the Diagnosis of Chronic Obstructive Pulmonary Disease

Gutiérrez ÁSA, Domínguez BA, Valenzuela PA

Language: Spanish
References: 28
Page: 247-256
PDF size: 547.25 Kb.


ABSTRACT

Background: Chronic obstructive pulmonary disease (COPD) is associated with important economic burden derived from health care utilization due to high morbidity rate and inpatient hospitalizations, as well as significant social burden. It is needed to develop strategies to confront clinical and social burden of this disease.
Objective: To evaluate the diagnostic accuracy of elements of clinical examination in patients diagnosed with COPD, confirmed later with spirometry and to estimate the economic investment that represented the delay of the confirmatory result.
Patients and method: An observational, prospective and longitudinal study was done with a cohort of 101 patients clinically diagnosed with COPD, from March 2010 to April 2013. Baseline characteristics of patients and the following data were collected: smoking history, use of biomass and occupational exposure, presence of cough, shortness of breath, coughing and wheezing. The spirometric results of FEV1, FVC and FEV1/FVC ratio were also recorded.
Results: Based on the FEV1/FVC ratio, 70% of the patients lacked spirometric sustenance for EPOC. Age older than 65 years corresponded to the most relevant criterion to discriminate among patients diagnosed clinically with COPD of those in which the diagnosis was confirmed by spirometry.
Conclusions: It is important to have an equipment of spirometry. We suggest that in patients with less than or equal to 65 years old, with COPD clinical criteria, the beginning of medical treatment should be postponed up to having spirometric results.


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