RESUMEN
COPD is one of the leading causes of mortality and increased morbidity in developed world. In advanced disease it also imposes an important economic burden on societies. The main etiologic factor for COPD is tobacco smoking. The aim of the study was to asses if the awareness of airflow obstruction combined together with a minimal antismoking advice in middle aged smokers increases the quitting rate. Out of smokers participating in mass spirometric screening for COPD in five polish towns, we invited 734 (300 with airflow limitation and 247 with normal lung function) for a follow-up. During the second visit, at one year, spirometry was performed and smoking status was assessed. Non-smoking was validated with carbon monoxide measurements in exhaled breath. Patients who did not come for the follow-up visit were considered as smokers. Of 734 smokers invited, 543 (74%) presented for the follow-up visit. All smokers tried to modify the habit. Number of cigarettes smoked at one year was reduced by -5.5 (p < 0.001) in patients with airflow limitation and -2.2 (ns) in smokers with normal lung function. One year quit rate in smokers with airflow limitation was 11.1% vs 7.6% in smokers with normal lung function (ns). When the calculation was made for those who had the follow-up the quit rates were 15.1% vs 9.9% (p < 0.05). Cessation of smoking was correlated with lung function. Those smokers who stopped smoking permanently or tried to quit had lower FEV1 (p < 0.01) and FEV1/FVC (p < 0.05), than those who continued to smoke.
Asunto(s)
Enfermedad Pulmonar Obstructiva Crónica/prevención & control , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Cese del Hábito de Fumar , Fumar/efectos adversos , Adulto , Factores de Edad , Anciano , Concienciación , Consejo , Femenino , Humanos , Masculino , Tamizaje Masivo/métodos , Persona de Mediana Edad , Polonia/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/etiología , Fumar/epidemiología , Prevención del Hábito de Fumar , Espirometría , Factores de Tiempo , Capacidad VitalRESUMEN
UNLABELLED: COPD is the most frequent chronic lung disease in Poland. The disease is however under-diagnosed, especially at the early stages. The aim of the study was to assess the efficacy of spirometric screening for COPD in middle aged smokers. Informations on causes and symptoms of COPD were disseminated in mass media in 14 large cities. Subject aged over 39 and with smoking history of > 10 packyears were invited for a free spirometry in local chest clinic. However, everyone attending had the spirometry performed. Spirometry was performed according to ATS recommendations. Airway obstruction (AO) was diagnosed when FEV1/FVC < 85% of N and categorised as mild (FEV1 > 70% of N), moderate (FEV1 50-69% of N) or severe (FEV1 < 50% of N). Spirometry was accompanied by an antismoking advice. RESULTS: 12.781 subjects were screened (mean age 52 +/- 12 years, 57% males). In 8.269 subjects who complied with inclusion criteria AO was diagnosed in 29.8% (mild in 10.9%, moderate in 12% and severe in 6.9%). In smokers < 40 years of age and a history of < 10 packyears AO was found in 8.8% (mild in 6.0%, moderate in 1.8% and severe in 1.0%). CONCLUSION: Mass spirometry is an effective and easy method for early detection of COPD.
Asunto(s)
Enfermedades Pulmonares Obstructivas/diagnóstico , Tamizaje Masivo/métodos , Espirometría , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Obstrucción de las Vías Aéreas/diagnóstico , Obstrucción de las Vías Aéreas/epidemiología , Niño , Preescolar , Enfermedad Crónica , Comorbilidad , Humanos , Lactante , Recién Nacido , Enfermedades Pulmonares Obstructivas/epidemiología , Persona de Mediana Edad , Polonia/epidemiología , Fumar/epidemiologíaRESUMEN
Accuracy of qualification to LTOT and the results of one year of treatment were assessed in 12 regional centres in Poland. 390 patients with advances respiratory failure entered the study. There were 305 patients with COPD and 85 patients with other chronic lung diseases. The accuracy of qualification to LTOT in Poland is satisfactory--2/3 of patients were accepted to treatment with severe hypoxaemia (PaO2 55 mm Hg), the remainder with moderate hypoxaemia (PaO2 = 56-65 mm Hg) and signs of tissue hypoxia. After one year of treatment 6.5% of patients did not need LTOT and 13% stopped to fulfill the single entry criterion still needing treatment.