High Prevalence of Chronic Obstructive Pulmonary Disease Among Veterans in the Urban Midwest
High Prevalence of Chronic Obstructive Pulmonary Disease Among Veterans in the Urban Midwest
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DOI：
10.7205/milmed-d-10-00377
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发表时间：
2011-05-01
影响因子：
1.2
通讯作者：
Panos, Ralph J.
中科院分区：
文献类型：
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作者：
Murphy, Daniel E.;Chaudhry, Zeshan;Panos, Ralph J.
虽然慢性阻塞性肺疾病(COPD)是退伍军人卫生保健管理局内发病率和死亡率的主要原因，但其患病率和认知度尚不清楚。我们在辛辛那提退伍军人管理医疗中心测量了气流限制并诊断为COPD。参与者是326名门诊患者，他们进行了肺活量测定，并完成了问卷调查。以1秒用力呼气量(FEV1)/用力肺活量(FVC)和0.7(固定比率)和(FEV1/FVC)/正常下限(LLn；1.0)为标准，比较COPD的医护人员诊断和自我诊断。按固定比率计算，COPD患病率为43%(95%可信区间：36.9，48.1)；按LLN计算，患病率为33%(95%可信区间：27.2，36.8)。18%的患者有医疗保健提供者记录，23%的患者自我报告患有COPD。医护人员诊断慢性阻塞性肺疾病的阳性预测值分别为79%和%，而患者分别为68%和62%；阴性预测值分别为%和74%，而患者为%和76%(固定比率和LLN)。辛辛那提退伍军人的COPD患病率高于美国普通人群。慢性阻塞性肺疾病在医疗保健提供者和退伍军人中的认可度都很低。
Although chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality within the Veterans Health care Administration, its prevalence and recognition are not known. We measured airflow limitation and diagnosed COPD at the Cincinnati Veteran's Administration Medical Center. Participants were 326 outpatients who performed spirometry and completed questionnaires. Health care-provider-diagnosis and self-diagnosis of COPD were compared with COPD defined by forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) < 0.7 (fixed ratio) and (FEV1/FVC)/lower limit of normal (LLN) < 1.0. COPD prevalence was 43% (95% confidence interval: 36.9, 48.1) by fixed ratio and 33% (95% confidence interval: 27.2, 36.8) by LLN. Eighteen percent of the patients had health care-provider-recorded and 23% had self-reported diagnoses of COPD. Positive predictive values for the diagnosis of COPD were 79% and 64% for healthcare providers versus 68% and 62% for patients; negative predictive values were 64% and 74% for healthcare providers versus 64% and 76% for patients (fixed ratio and LLN, respectively). COPD prevalence is higher among Cincinnati veterans than among general U.S. population. COPD is under-recognized by both health care providers and veterans.