Undetected chronic obstructive pulmonary disease and asthma in people over 50 years with persistent cough
Undetected chronic obstructive pulmonary disease and asthma in people over 50 years with persistent cough
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DOI：
10.3399/bjgp10x514738
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发表时间：
2010-07-01
影响因子：
5.9
通讯作者：
Verheij, Theo J. M.
中科院分区：
文献类型：
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作者：
Broekhuizen, Berna D. L.;Sachs, Alfred P. E.;Verheij, Theo J. M.
背景慢性阻塞性肺疾病（COPD）和哮喘在初级保健中诊断不足。目的确定因持续咳嗽就诊的中老年患者中COPD或哮喘的发生率。研究设计一项横断面研究，对353名年龄在50岁以上的患者进行研究，这些患者因持续咳嗽而就诊，不知道是否患有慢性阻塞性肺病或哮喘。背景：荷兰的全科医生。方法所有参与者都进行了广泛的诊断性检查，包括症状、体征、肺活量测定和身体体积脉搏图。专家小组对所有结果进行了研究，以诊断或排除COPD和/或哮喘。在41名参与者的样本中，通过计算Cohen’s K统计量来评估小组诊断的可重复性。在353名参与者中，102名（29%，95%可信区间[CI] = 24 - 34%）被诊断为COPD。在这102名参与者中，有14名被诊断为COPD和哮喘（4%,95% CI = 2 - 7%）。23名（7%,95% CI = 4 - 10%）参与者被诊断为哮喘（无COPD）。平均咳嗽持续时间为93天（中位40天）。专家小组的再现性良好（Cohen’s K = 0.90）。结论：在50岁以上因持续咳嗽就诊的患者中，经常存在未被发现的COPD或哮喘。
BackgroundChronic obstructive pulmonary disease (COPD) and asthma are underdiagnosed in primary care.AimTo determine how often COPD or asthma are present in middle-aged and older patients who consult their GP for persistent cough.Design of studyA cross-sectional study in 353 patients older than 50 years, visiting their GP for persistent cough and not known to have COPD or asthma.SettingGeneral practice in the Netherlands.MethodAll participants underwent extensive diagnostic workup, including symptoms, signs, spirometry, and body, plethysmography. All results were studied by an expert panel to diagnose or exclude COPD and/or asthma. The reproducibility of the panel diagnosis was assessed by calculation of Cohen's K statistic in a sample of 41 participants.ResultsOf the 353 participants, 102 (29%, 95% confidence interval [CI] = 24 to 34%) were diagnosed with COPD. In 14 of these 102 participants, both COPD and asthma were diagnosed (4%, 95% CI = 2 to 7%). Asthma (without COPD) was diagnosed in 23 (7%, 95% CI = 4 to 10%) participants. Mean duration of cough was 93 days (median 40 days). The reproducibility of the expert panel was good (Cohen's K = 0.90).ConclusionIn patients aged over 50 years who consult their GP for persistent cough, undetected COPD or asthma is frequently present.