Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel.
The Institute of Pulmonary Medicine, Hadassah Medical Center, Jerusalem 91000, Israel.
Medicina (Kaunas). 2023 Mar 22;59(3):632. doi: 10.3390/medicina59030632.
: COPD diagnosis requires relevant symptoms and an FEV1/FVC ratio of <0.7 post-bronchodilator on spirometry. Patients are frequently labeled as COPD based on clinical presentation and admitted to the hospital with this diagnosis even though spirometry is either not available or has never been performed. The aim of this study was to evaluate the accuracy of COPD diagnosis based on post-bronchodilator spirometry, following hospital admission for COPD exacerbation. : This is a retrospective study with a cross-sectional analysis of a subgroup of patients. Demographic and clinical data and pre-admission spirometry were collected from electronic records of patients hospitalized with a primary diagnosis of COPD. Patients without available spirometry were contacted for a pulmonary consultation and spirometry. Three groups were compared: patients with a confirmed COPD diagnosis (FEV1/FVC < 0.7), without COPD (FEV1/FVC > 0.7), and those who have never performed spirometry. : A total of 1138 patients with a recorded diagnosis of COPD were identified of which 233 patients were included in the analysis. Only 44.6% of patients had confirmed COPD according to GOLD criteria. In total, 32.6% of the patients had never undergone spirometry but were treated as COPD, and 22.7% had performed spirometry without evidence of COPD. Recurrent admission due to COPD was a strong predictor of a confirmed COPD diagnosis. : Among the patients admitted to the hospital with a COPD diagnosis, a high proportion were not confirmed by the current GOLD report or had never performed spirometry. Stricter implementation of the diagnostic criteria of COPD in admitted patients is necessary to improve diagnosis and the treatment outcomes in these patients.
COPD 的诊断需要相关症状和支气管扩张剂后 FEV1/FVC 比<0.7。由于临床症状，患者经常被诊断为 COPD，并因该诊断而入院，尽管没有进行或从未进行过肺量计检查。本研究旨在评估 COPD 急性加重入院后基于支气管扩张剂后肺量计检查的 COPD 诊断准确性。
这是一项回顾性研究，对一组患者进行了横断面分析。从因 COPD 住院的患者的电子病历中收集了人口统计学和临床数据以及入院前的肺量计检查。无法进行肺量计检查的患者将进行肺部会诊和肺量计检查。比较了三组：已确诊 COPD 患者（FEV1/FVC<0.7）、无 COPD 患者（FEV1/FVC>0.7）和从未进行过肺量计检查的患者。
共确定了 1138 例记录诊断为 COPD 的患者，其中 233 例患者纳入分析。根据 GOLD 标准，只有 44.6%的患者确诊为 COPD。共有 32.6%的患者从未进行过肺量计检查但被诊断为 COPD，22.7%的患者进行过肺量计检查但没有 COPD 证据。因 COPD 反复发作是确诊 COPD 的强烈预测因素。
在因 COPD 入院的患者中，很大一部分未被现行 GOLD 报告确认，或从未进行过肺量计检查。需要更严格地执行 COPD 的诊断标准，以改善这些患者的诊断和治疗效果。
