Underdiagnosis of COPD at primary health care clinics in the city of Aparecida de Goiânia, Brazil
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Data
2012
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Resumo
Objective: To estimate the prevalence of undiagnosed COPD among individuals with risk factors for the disease
treated at primary health care clinics (PHCCs) in the city of Aparecida de Goiânia, Brazil. Methods: Inclusion
criteria were being ≥ 40 years of age, having a > 20 pack-year history of smoking or a > 80 hour-year history
of exposure to biomass smoke, and seeking medical attention at one of the selected PHCCs. All subjects
included in the study underwent spirometry for the diagnosis of COPD. Results: We successfully evaluated
200 individuals, mostly males. The mean age was 65.9 ± 10.5 years. The diagnosis of COPD was confirmed
in 63 individuals, only 18 of whom had been previously diagnosed with COPD (underdiagnosis rate, 71.4%).
There were no significant differences between the subgroups with and without a previous diagnosis of COPD in
relation to demographics and risk factors. However, there were significant differences between these subgroups
for the presence of expectoration, wheezing, and dyspnea (p = 0.047; p = 0.005; and p = 0.047, respectively).
The FEV 1 and FEV 1 /FVC ratio, expressed as percentages of the predicted values, were significantly lower in the
subjects with a previous diagnosis of COPD, which was predominantly mild or moderate in both subgroups.
Conclusions: The rate of underdiagnosis of COPD was high at the PHCCs studied. One third of the patients
with risk factors for COPD met the clinical and functional criteria for the disease. It seems that spirometry is
underutilized at such facilities.
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Pulmonary disease, Spirometry, Chronic obstructive/diagnosis, Primary health care, Doença pulmonar obstrutiva crônica/diagnóstico, Espirometria, Atenção primária à saúde
Citação
QUEIROZ, Maria Conceição de Castro Antonelli Monteiro de; MOREIRA, Maria Auxiliadora Carmo; RABAHI, Marcelo Fouad. Subdiagnóstico de DPOC na atenção primária em Aparecida de Goiânia, Goiás. Jornal Brasileiro de Pneumologia, Brasília, v. 38, n. 6, p. 692-699, 2012.