Are patient characteristics helpful in recognizing mild COPD (GOLD I) in daily practice?

Scand J Prim Health Care. 2006 Dec;24(4):237-42. Geijer RM, Sachs AP, Verheij TJ, Lammers JW, Salome PL, Hoes AW. Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands.

OBJECTIVE. To determine whether in a high-risk group of middle-aged male current smokers, patient characteristics are useful to recognize mild COPD (GOLD stage I).

DESIGN. In a cross-sectional study spirometry was performed according to the American Thoracic Society criteria. COPD was defined according to the GOLD criteria for COPD.

SETTING. Primary care.

SUBJECTS. Male smokers, aged 40-65 years, without documented lung disease in the population at large.

MAIN OUTCOME MEASURES. Medical records were scrutinized to collect patient characteristics. Multiple logistic regression analysis was used to identify independent determinants of mild COPD.

RESULTS. A total of 567 subjects participated. COPD, defined by a FEV1/FVC ratio < 0.7, was detected in 170 subjects (30.0%, 95% CI 26.2-33.9%). In 149 subjects (26.3%; 22.7-30.1%) COPD was mild (GOLD stage I) and in 21 subjects (3.7%; 2.3-5.6%) moderate (GOLD stage II). Only age and cough were independently associated with the presence of mild COPD. The ability of these determinants to discriminate between subjects with or without mild COPD was relatively poor (ROC area 0.65). Therefore no prediction rule was developed.

CONCLUSION. Our results indicate that patient characteristics are not helpful to recognize mild COPD (GOLD stage I) in middle-aged male smokers.




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