Medical Care According to Risk Level and Adaptation to Spanish COPD Guidelines (Gesepoc): The Epoconsul Study
Por:
Calle Rubio M, Rodríguez Hermosa JL, Soler-Cataluña JJ, López-Campos JL, Alcazar Navarrete B, Soriano JB, Rodríguez Gónzalez-Moro JM, Fuentes Ferrer ME and Miravitlles M
Publicada:
1 may 2018
Ahead of Print:
1 feb 2018
Categoría:
Pulmonary and respiratory medicine
Resumen:
Introduction: EPOCONSUL is the first national audit to analyze medical care for COPD in pulmonology departments in Spain. The main objective was to perform a retrospective analysis to determine the distribution of GesEPOC 2017 COPD risk levels and to evaluate clinical activity according to the new recommendations.
Material and methods: This is a cross-sectional clinical audit in which consecutive COPD cases were recruited over one year. The study evaluated risk and clinical phenotype according to GesEPOC 2017, and their correlation with the clinical interventions employed.
Results: The most common risk category was high risk (79.8% versus 20.2%; p < 0.001), characterized by a higher level of severity on BODE and BODEx indexes, and a higher comorbidity burden. The most common phenotype was non-exacerbator. The most commonly used treatment in low-risk patients was bronchodilator monotherapy (34.8%) and triple therapy in high-risk patients (53.7%). High risk was most frequently characterized by phenotype (57.6% versus 52%; p = 0.014) and pulmonary function test results: lung volume (47.7% versus 35.8%; p < 0.001), lung diffusion (51.4% versus 42.1%; p < 0.001) and walk test (37.8% versus 15.8%; p < 0.001).
Conclusions: Most patients treated in pulmonology departments were high-risk and non-exacerbator phenotype. Clinical interventions differed according to risk level and mainly followed GesEPOC recommendations, although there is significant room for improvement. (C) 2017 SEPAR. Published by Elsevier Espana, S.L.U. All rights reserved.
Filiaciones:
Calle Rubio M:
Servicio de Neumología, Instituto de Investigación Sanitaria (IdISSC), Hospital Clínico San Carlos, Madrid, España
Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
Rodríguez Hermosa JL:
Servicio de Neumología, Instituto de Investigación Sanitaria (IdISSC), Hospital Clínico San Carlos, Madrid, España
Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
:
Servicio de Neumología, Hospital de Arnau de Villanova, Valencia, España
CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España
López-Campos JL:
CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España
Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, España
Alcazar Navarrete B:
Servicio de Neumología, Hospital de Alta Resolución de Loja, Granada, España
Soriano JB:
Instituto de Investigación, Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, España
Rodríguez Gónzalez-Moro JM:
Servicio de Neumología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares (Madrid), España
Fuentes Ferrer ME:
Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
UGC de Medicina Preventiva, Instituto de Investigación Sanitaria (IdISSC), Hospital Clínico San Carlos, Madrid, España
Miravitlles M:
Servicio de Neumología, Hospital Universitario Vall d'Hebrón, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, España
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