COPD: problems in diagnosis and measurement

Weiss, ST; DeMeo, DL; Postma, D.S.

doi:10.1183/09031936.03.00077702

Cited by 35 publications

(21 citation statements)

References 84 publications

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“…One of the difficulties of conducting clinical outcomes research in COPD is the high prevalence of comorbid conditions, especially those that are also caused by cigarette smoking (5). Persons with chronic airflow obstruction are known to have a substantially increased risk of coronary artery disease and sudden cardiac death (6 -10), and the degree of airflow obstruction is highly correlated with systemic inflammatory markers that are associated with coronary artery disease (11).…”

Section: Introductionmentioning

confidence: 99%

Trends and Cardiovascular Co-morbidities of COPD Patients in the Veterans Administration Medical System, 1991–1999

Mapel

Dedrick

Davis

2005

COPD: Journal of Chronic Obstructive Pulmonary Disease

113

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Persons with Chronic Obstructive Pulmonary Disease (COPD) are at risk for developing other smoking-related complications, including cardiac and vascular diseases. Information about the prevalence and incidence of these conditions is needed to anticipate their occurrence in clinical research. We conducted a cohort study using longitudinal administrative data to describe the prevalence and incidence of cardiovascular (CV) diseases among COPD patients treated by the Veterans Administration Medical System. The COPD cohort included all persons with a diagnosis of COPD admitted to a Veterans Administration Medical System hospital (N = 70,679) or seen in a outpatient clinic (N = 314,209) in fiscal year 1998. Each COPD patient was matched to a Veteran of the same age and gender who did not have a COPD diagnosis, creating a non-COPD cohort for comparison. Among all hospitalized Veterans, the prevalence of COPD steadily increased from 1991 to 1999, although the total number of Veterans hospitalized during this time period decreased by more than one-third. Among COPD patients hospitalized in 1998, the prevalence of coronary artery disease, congestive heart failure, and atrial fibrillation were very high (33.6%, 24.4%, and 14.3%, respectively) and significantly higher than those seen among the matched non-COPD cohort (27.1%, 13.5%, and 10.4%; p < 0.001). Among COPD outpatients, increased complications were found in every CV disease category with rate ratios that were greater than observed among inpatients. We conclude that CV diseases are remarkably prevalent among Veterans with COPD, and their incidence is likely to increase as the Veteran population ages.

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Section: Introductionmentioning

confidence: 99%

Trends and Cardiovascular Co-morbidities of COPD Patients in the Veterans Administration Medical System, 1991–1999

Mapel

Dedrick

Davis

2005

COPD: Journal of Chronic Obstructive Pulmonary Disease

113

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“…It has been shown that COPD is the most rapidly increasing cause of death in individuals older than 65 years of age, which represents the most rapidly growing segment of the population in developed countries. Disability from COPD is expected to rise by 2020 with aging of the population and the increase in disease prevalence (Weiss et al 2003). …”

Section: Introductionmentioning

confidence: 99%

Health-related quality of life in outpatients with COPD in daily practice: the <em>VICE</em> Spanish study

Martín

Moro²,

Izquierdo³

et al. 2008

COPD

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BackgroundThe objective of this study was to measure health-related quality of life (HRQL) in outpatients with chronic obstructive pulmonary disease (COPD) and to assess differences in HRQL according to age, gender, and severity of COPD.MethodsA total of 9405 patients (79% men, mean age 68 years) participated in a cross-sectional study. HRQL was measured with the Short Form 12 Health Survey Questionnaire (SF-12). Severity of COPD was graded into three levels according to forced expiratory volume in one second value.ResultsCOPD severity was mild in 33.8% of cases, moderate in 49.3% and severe in 16.8%. The mean physical component summary (PCS-12) and mental component summary (MCS-12) scores were 36.8 ± 10.4 and 47.2 ± 11.2, respectively. General health and physical functioning domains were those with the lowest scores. The mean MCS-12 scores were significantly higher in men (47.9 ± 10.9) than in women (44.1 ± 11.8) (P < 0.001). Patients older than 60 years rated HRQL worse than patients aged 40–59 years. There were statistically significant differences according to severity of disease in the mean scores of all domains of the PCS-12 and MCS-12 scales.ConclusionsThe present findings show the influence of female gender, older age and moderate-to-severe of airflow limitation on HRQL in outpatients with COPD attended in daily practice.

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“…'Never-smokers' can also contract COPD but this is restricted to a prevalence of about 4-5% of patients reporting physician-diagnosed COPD. 24 Grounded theory requires continuous theoretical sampling to direct further data collection. Given the limited number of possible patients, sampling was mainly purposeful and intended to describe the research area.…”

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confidence: 99%

COPD patients' perspectives at the time of diagnosis: a qualitative study

Arne

Emtner

Janson

et al. 2007

Primary Care Respiratory Journal

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Aims: To gain an understanding of patients´ perspectives and perceptions of chronic obstructive pulmonary disease (COPD) at the time of diagnosis.Methods: A qualitative study using grounded theory. Ten patients in primary care in Sweden, newly diagnosed with COPD or with suspected COPD, were interviewed.Results: The analysis created a process model with a core category "Consequences of smoking" and main categories "Shame", "Appearance of symptoms", "Adaptation", "Reflection", and "Action". "Restrictions in physical capacity" was a key indicator of evolving disease and "Getting a diagnosis" was crucial for the patient. Conclusions:The COPD patient needs a clear diagnosis at an early stage. It is important to seize the opportunity when the presumptive COPD patient is receptive towards support and further action. To detect and support the patient, health professionals must be aware of minor symptoms and underlying mechanisms of possible shame.

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COPD: problems in diagnosis and measurement

Cited by 35 publications

References 84 publications

Trends and Cardiovascular Co-morbidities of COPD Patients in the Veterans Administration Medical System, 1991–1999

Trends and Cardiovascular Co-morbidities of COPD Patients in the Veterans Administration Medical System, 1991–1999

Health-related quality of life in outpatients with COPD in daily practice: the <em>VICE</em> Spanish study

COPD patients' perspectives at the time of diagnosis: a qualitative study

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