Department of Health Science and Technology, Medical Informatics Group, Aalborg University, Aalborg, Denmark.
Respir Care. 2019 Jan;64(1):63-70. doi: 10.4187/respcare.06296. Epub 2018 Aug 7.
COPD is largely underdiagnosed. Patients with undiagnosed COPD need to be diagnosed to ensure early treatment institution. It is therefore relevant to obtain a more profound understanding of the characteristics of patients with undiagnosed COPD to improve COPD case finding. This study aimed to explore the characteristics of subjects with undiagnosed COPD from the United States National Health and Nutrition Examination Survey (NHANES) dataset (2007-2012) based on post-bronchodilator spirometry.
A multitude of statistical tests were performed to explore the potential characteristics of subjects with undiagnosed COPD. A total of 1,098 subjects with a post-bronchodilator FEV/FVC < 0.7 or lower limit of normal (LLN) were included in the final sample.
Undiagnosed subjects experienced less phlegm ( < .001), wheezing ( < .001), and chest pain ( < .001) than subjects diagnosed with COPD. They were characterized by less shortness of breath ( < .001), fewer work/school days lost to wheezing ( < .001), less sleep disturbance ( < .001), and less difficulty socializing ( < .001). The undiagnosed subjects felt less depressed ( < .001). Additionally, they were less likely to have asthma ( < .001). The annual household income was higher among the undiagnosed subjects ( < .001), and they were also characterized by higher FEV ( < .001), and FVC ( < .001).
Subjects with undiagnosed COPD were characterized by fewer symptoms and had better lung function than their diagnosed counterparts.
COPD 很大程度上被漏诊。需要对未被诊断出的 COPD 患者进行诊断,以确保尽早开始治疗。因此,深入了解未被诊断出的 COPD 患者的特征对于提高 COPD 的检出率具有重要意义。本研究旨在通过美国国家健康和营养调查(NHANES)(2007-2012 年)的支气管扩张后肺活量测定数据集,探索基于支气管扩张后肺活量测定的未被诊断出的 COPD 患者的特征。
进行了多种统计检验,以探索未被诊断出的 COPD 患者的潜在特征。最终样本共纳入 1098 例支气管扩张后 FEV/FVC<0.7 或低于正常值下限(LLN)的患者。
与被诊断为 COPD 的患者相比,未被诊断出的患者咳痰(<0.001)、喘息(<0.001)和胸痛(<0.001)的情况更少。他们的呼吸困难(<0.001)、因喘息而丧失的工作/上学天数(<0.001)、睡眠障碍(<0.001)和社交困难(<0.001)也较少。未被诊断出的患者抑郁程度较低(<0.001)。此外,他们患哮喘的可能性较小(<0.001)。未被诊断出的患者的家庭年收入较高(<0.001),他们的 FEV(<0.001)和 FVC(<0.001)也更高。
与被诊断为 COPD 的患者相比,未被诊断出的 COPD 患者的症状较少,肺功能更好。