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Revista Uruguaya de Medicina Interna

Print version ISSN 2393-6797On-line version ISSN 2393-6797

Abstract

BETOLAZA, Sofía de et al. Descriptive study of a population of COPD patients assisted at the Pasteur Hospital: severity and impact on daily life. Rev. Urug. Med. Int. [online]. 2018, vol.3, n.2, pp.13-21. ISSN 2393-6797.  http://dx.doi.org/10.26445/rmu.3.2.2.

Introduction:

COPD is an important sanitary problem. It is the fourth cause of death worldwide, with a prevalence of 19.7% in Uruguay. It is a preventable and treatable disease, characterized by persistent airflow limitation associated to chronic inflammatory airway response and pulmonary parenchima destruction as a consecuence of exposure to noxious particles.

Objectives:

Describe clinical and demographic features of a group of COPD patients. Determine the disease´s severity and its impact over the quality of life.

Materials and methods:

This is an observational, descriptive and transversal study which included 61 inpatients of Hospital Pasteur´s Internal Medicine service who were summoned for their follow-up at the COPD outpatient clinic between October 1st 2015 and December 31st 2016. The inclusion criteria were: both genders, over 40 years of age, presence of risk factors, congruent symptoms and signs or previous COPD diagnosis. The exclusion criteria were: moderate to severe cognitive impairment, bedridden patients, pregnancy, active pulmonary tuberculosis, neuromuscular diseases. The sampling was done by convenience. Data was obtained from ambulatory follow-up and processed with the programme EPI-DATA version 3.1 and PSPP.

Results:

The diagnosis of COPD was confirmed by spirometry in 42 of the 61 summoned patients. The mean age of COPD patients was 63 years (± 11), prevailing among males (24, 57.1%). The majority had a low education level (incomplete primary schooling in 15 patients, 35.7%). Smoking constituted a risk factor in 100%, with mean pack-year index (PYI) of 81.9 (± 59.8). More than half associated at least two risk factors. 21 patients (50%) had grade 3 mMRC (Modified British Medical Research Council) dyspnea, while 26 (61.9%) had frequent exacerbations. The mean value obtained in the COPD Assessment Test (CAT) was 19.58 (SD 10.56). Therefore, most patients belonged to groups D (17, 40.4%) and C (9, 21.4%) defined by the GOLD Report 2017. Where airflow limitation is concerned, the majority corresponded to group GOLD 2 or moderate limitation.

Conclusions:

He existence of selection biases determined a small number of COPD patients. The average age and sex agreed with international data. The low level of instruction may have implications for adherence to controls and treatment. The average API was higher than in international studies. The association of risk factors was linked to worse results. The COPD patients analyzed were highly symptomatic, presented frequent exacerbations and had an important impact on quality of life, unlike that observed in large European studies that show better symptomatic control of included COPD. The foregoing did not correlate with a severe limitation to air flow, as indicated in the international literature.

Keywords : COPD; smoking; exacerbations; impact on daily life.

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