Personalized Medicine, Asthma and Allergy, Humanitas Research Hospital, Via Alessandro Manzoni 56, Rozzano, MI, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, MI, Italy.
Allergy and Respiratory Diseases, University of Catania, AOU Policlinico "Vittorio Emanuele", Via Santa Sofia 78, Catania, Italy.
Respir Med. 2018 Sep;142:48-52. doi: 10.1016/j.rmed.2018.07.015. Epub 2018 Jul 24.
The diagnosis of both asthma and chronic obstructive pulmonary disease (COPD) consists of a combination of classical symptoms and signs, and the evidence of consistent lung function abnormalities. Spiromety has been reported to be underused, possibly for practical difficulties in accessing to a lung function lab. This may lead to misdiagnosis of both asthma and COPD. We aimed to evaluate the frequency of spirometry use and the concordance between doctor-diagnosed asthma and COPD and spirometric patterns, in an unselected cohort of patients sent by general practitioners to perform a spirometry.
The first 300 patients consecutively enrolled patients performed spirometry and bronchodilator test with salbutamol 400 mcg. Demographic, clinical and lung function data have been collected.
128 patients (42.7%) declared a doctor-diagnosed asthma and 75 (25%) a doctor-diagnosis of COPD; the remaining subjects never had received any respiratory diagnosis. Only 112 patients with doctor-diagnosed asthma (55.2%) and 114 (56.2%) with doctor-diagnosed COPD have ever performed a spirometry in their entire life (average time since the last spirometry was about 47.0 months). Eighty-nine (69.5%) and 10 (13.3%) patients with respectively doctor-diagnosed asthma and COPD had concordant spirometric patterns with their known diseases.
we described a worrying lack of use of spirometry and a high proportion of misdiagnosis, in patients with suspect chronic airway inflammatory diseases and cared by primary care physicians. Novel strategies to overcome this situation include should be implemented to give a better care to our patients.
哮喘和慢性阻塞性肺疾病（COPD）的诊断包括经典症状和体征的组合，以及一致的肺功能异常的证据。已经报道了肺功能检查的使用不足，可能是因为难以获得肺功能实验室的实际困难。这可能导致哮喘和 COPD 的误诊。我们旨在评估在未经选择的由全科医生转介进行肺功能检查的患者队列中，肺功能检查的使用频率以及医生诊断的哮喘和 COPD 与肺功能模式之间的一致性。
前 300 名连续入组的患者进行了肺功能检查和沙丁胺醇 400 mcg 支气管扩张剂试验。收集了人口统计学、临床和肺功能数据。
128 名患者（42.7%）报告了医生诊断的哮喘，75 名患者（25%）报告了 COPD；其余患者从未接受过任何呼吸系统诊断。只有 112 名有医生诊断的哮喘患者（55.2%）和 114 名有医生诊断的 COPD 患者（56.2%）在其一生中曾进行过肺功能检查（最近一次肺功能检查的平均时间约为 47.0 个月）。分别有 89 名（69.5%）和 10 名（13.3%）有医生诊断的哮喘和 COPD 的患者的肺功能模式与已知疾病相符。
我们描述了一种令人担忧的情况，即在由初级保健医生照顾的疑似慢性气道炎症性疾病患者中，肺功能检查的使用不足和误诊率较高。应实施新的策略来克服这种情况，以更好地为我们的患者提供护理。
