Choi Sun Mi, Lee Jinwoo, Park Young Sik, Lee Chang-Hoon, Lee Sang-Min, Yim Jae-Joon, Kim Young Whan, Han Sung Koo, Yoo Chul-Gyu
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
PLoS One. 2015 Jan 27;10(1):e0115787. doi: 10.1371/journal.pone.0115787. eCollection 2015.
Despite being a major public health problem, chronic obstructive pulmonary disease (COPD) remains underdiagnosed, and only 2.4% COPD patients are aware of their disease in Korea. The objective of this study was to estimate the prevalence of COPD detected by spirometry performed as a preoperative screening test and to determine the Global Initiative for Chronic Obstructive Lung Disease (GOLD) group distribution and self-awareness of COPD.
We reviewed the medical records of adults (age, ≥ 40 years) who had undergone spirometry during preoperative screening between April and August 2013 at a tertiary hospital in Korea. COPD was defined as a postbronchodilator forced expiratory volume in 1 s/forced vital capacity ratio of <0.7. We analyzed self-administered COPD questionnaires for the assessment of the frequency of acute exacerbation over the previous year and dyspnea severity using the modified Medical Research Council dyspnea scale and COPD assessment test.
Among 3029 patients aged >40 years who had undergone spirometry as a preoperative screening test, 474 (15.6%; 404 men; median age, 70 years; range, 44-93 years) were diagnosed with COPD. Only 26 (5.5%) patients reported previous diagnosis of COPD (2.1%), emphysema (0.8%), or chronic bronchitis (2.5%). The GOLD group distribution was as follows: 63.3% in group A, 31.2% in group B, 1.7% in group C, and 3.8% in group D.
The prevalence of COPD diagnosed by preoperative spirometry was 15.6%, and only 5.5% patients were aware of their disease. Approximately one-third of the COPD patients belonged to GOLD groups B, C, and D, which require regular treatment.
尽管慢性阻塞性肺疾病（COPD）是一个主要的公共卫生问题，但它仍然诊断不足，在韩国只有2.4%的COPD患者知晓自己的病情。本研究的目的是评估术前筛查时通过肺功能测定检测出的COPD患病率，并确定慢性阻塞性肺疾病全球倡议组织（GOLD）分组分布情况以及COPD的自我知晓率。
我们回顾了2013年4月至8月在韩国一家三级医院进行术前筛查时接受肺功能测定的成年人（年龄≥40岁）的病历。COPD被定义为支气管扩张剂使用后1秒用力呼气容积/用力肺活量比值<0.7。我们分析了自我填写的COPD问卷，以使用改良的医学研究委员会呼吸困难量表和COPD评估测试评估上一年急性加重的频率和呼吸困难严重程度。
在3029名年龄>40岁且接受了术前筛查肺功能测定的患者中，474名（15.6%；404名男性；中位年龄70岁；范围44 - 93岁）被诊断为COPD。只有26名（5.5%）患者报告曾被诊断为COPD（2.1%）、肺气肿（0.8%）或慢性支气管炎（2.5%）。GOLD组分布如下：A组63.3%，B组31.2%，C组1.7%，D组3.8%。
术前肺功能测定诊断出的COPD患病率为15.6%，只有5.5%的患者知晓自己的病情。大约三分之一的COPD患者属于需要定期治疗的GOLD组B、C和D。
