Abstract
Introduction: COPD is frequently misdiagnosed or undiagnosed, which can delay disease management interventions.
Aims and objectives: to identify the clinical profile of COPD patients (pts) diagnosed in an advanced stage of disease.
Methods: We review retrospectively data of COPD pts admitted between 2013 and 2014 for acute exacerbation (AE) of COPD.
Results: 89 male-smokers pts were included with average age of 65 years (48 to 89 years). COPD was classified: stage C (20%) and D (80%). In half of the cases, pts had comorbidity: diabetes in 13% and cardiovascular disease in 37%.Twenty-four pts (27%) had severe exacerbation with stay on intensive care unit, 6 pts required invasive ventilation. Pts had acute respiratory failure with PaO2< 45 mmHg in 75% of cases. 30% required non invasive ventilation. Infectious cause of exacerbation was the most frequent (85%). The follow-up of pts find that the rate of AE was at least 1/year in 88% and >2/year in 12%. 15% of pts had infectious pneumonia, 35% had anemia. 48% of pts required long-term oxygen therapy (LOT) and home NIV was indiquated in22%. COPD treatment was based on inhaled corticosteroids in all cases associated with inhaled long acting bronchodilators in 65% and theophylline in 78%. Compliance to LOT, home NIV and medical therapy was difficult because of several constraints like advanced age of these pts and comorbidity.
Conclusions: the role of primary care to participate on the early diagnosis of COPD in smoking aged pts need to be evaluated to improve prognosis of these disease if diagnosed earlier and to reduce costs of management.
- Copyright ©ERS 2015