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[慢性阻塞性肺疾病:发病率、死亡率及医疗负担]

[Chronic obstructive pulmonary disease: Morbimortality and healthcare burden].

作者信息

Gómez Sáenz J T, Quintano Jiménez J A, Hidalgo Requena A, González Béjar M, Gérez Callejas M J, Zangróniz Uruñuela M R, Moreno Vilaseca A, Hernández García R

机构信息

Medicina de Familia y Comunitaria, Centro de Salud de Nájera, Servicio Riojano de Salud, Nájera, La Rioja, España.

Medicina de Familia y Comunitaria, Centro de Salud Lucena 1, Servicio Andaluz de Salud, Lucena, Córdoba, España.

出版信息

Semergen. 2014 May-Jun;40(4):198-204. doi: 10.1016/j.semerg.2013.12.009. Epub 2014 Mar 15.

Abstract

Chronic obstructive pulmonary disease (COPD) is an enormous public health problem and of growing importance due to its high prevalence, elevated morbimortality, and socioeconomic costs. Many Spanish epidemiological studies report a prevalence of 10% of the adult population, with its growth appearing to have stabilised. Nevertheless, over 75% of cases are still underdiagnosed. The diagnosis of mild and moderate obstruction is associated with a higher survival and lower costs (14 years and €9,730) compared to 10 years survival and €43,785 of patients diagnosed in the severe obstruction phase. COPD was the fourth cause of death in Spain in 2011, although the adjusted mortality rates have decreased more than 20% in the last decade, particularly in males. Patients with advanced COPD die from it, but patients with mild or moderate COPD die due to cardiovascular diseases or cancer (mainly of the lung). It is estimated that the annual cost of the disease is around 3,000 million Euros. These increase with the spirometric severity, and is mainly associated with exacerbations (almost 60% of the direct costs). Comorbidity, that is the presence of diseases that coexist with the studied disease, is higher in patients with COPD than in the general population and affects health results.

摘要

慢性阻塞性肺疾病(COPD)是一个巨大的公共卫生问题,鉴于其高患病率、高病亡率及社会经济成本,其重要性日益凸显。许多西班牙的流行病学研究报告显示,成年人口中的患病率为10%,且其增长似乎已趋于稳定。然而,超过75%的病例仍未得到诊断。与重度阻塞阶段确诊患者的10年生存期及43,785欧元相比,轻度和中度阻塞的诊断与更高的生存率及更低的成本(14年和9,730欧元)相关。COPD在2011年是西班牙第四大致死原因,尽管在过去十年中调整后的死亡率下降了20%以上,尤其是在男性中。晚期COPD患者死于该病,但轻度或中度COPD患者死于心血管疾病或癌症(主要是肺癌)。据估计,该疾病的年度成本约为30亿欧元。这些成本随着肺功能测定严重程度的增加而增加,并且主要与病情加重有关(几乎占直接成本的60%)。合并症,即与所研究疾病共存的疾病,在COPD患者中比在一般人群中更为常见,并且会影响健康结果。

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