Steuten Lotte M G, Creutzberg Eva C, Vrijhoef Hubertus J M, Wouters Emiel F
Department of Health Care Studies, Faculty of Health Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Prim Care Respir J. 2006 Apr;15(2):84-91. doi: 10.1016/j.pcrj.2005.09.001. Epub 2005 Dec 19.
To describe the distribution of COPD disease severity in primary care based on airway obstruction, and to assess the extent to which dyspnoea scores, body mass index (BMI) and fat free mass (FFM) index contribute to the distribution of COPD severity in primary care.
Cross sectional population-based study.
317 patients with COPD were recruited from an outpatient disease management programme. Prevalence of moderate to severe dyspnoea, underweight, obesity and FFM depletion by GOLD stage were measured.
According to GOLD guidelines, 29% of patients had mild COPD, 48% moderate, 17% severe and 5% very severe. A substantial number of patients classified as GOLD stage 2 reported severe dyspnoea (28.1%) and/or suffered from FFM depletion (16.3%). Prevalence of low body weight strongly increased in GOLD stage 4. Prevalence of obesity is highest in GOLD stages 1 and 2.
The use of a multidimensional grading system, taking into account dyspnoea as well as the nutritional status of COPD patients, is likely to influence the distribution of disease severity in a primary care population. This might have implications for prevention, non-medical treatment, and estimates of health care utilisation in primary care.
基于气道阻塞描述初级保健中慢性阻塞性肺疾病（COPD）疾病严重程度的分布情况，并评估呼吸困难评分、体重指数（BMI）和去脂体重（FFM）指数在初级保健中对COPD严重程度分布的影响程度。
基于人群的横断面研究。
从门诊疾病管理项目中招募317例COPD患者。测量按慢性阻塞性肺疾病全球倡议（GOLD）分级的中重度呼吸困难、体重过低、肥胖和去脂体重减少的患病率。
根据GOLD指南，29%的患者患有轻度COPD，48%为中度，17%为重度，5%为极重度。大量被归类为GOLD 2级的患者报告有严重呼吸困难（28.1%）和/或患有去脂体重减少（16.3%）。体重过低的患病率在GOLD 4级中大幅增加。肥胖患病率在GOLD 1级和2级中最高。
使用考虑到呼吸困难以及COPD患者营养状况的多维分级系统，可能会影响初级保健人群中疾病严重程度的分布。这可能对初级保健中的预防、非药物治疗以及医疗保健利用的估计产生影响。
