Diagnosis of COPD in hospitalised patients


Por: Pellicer Císcar C, Soler Cataluña JJ, Andreu Rodríguez AL and Bueso Fabra J

Publicada: 1 feb 2010
Categoría: Pulmonary and Respiratory Medicine

Resumen:
Objective: To examine the quality of COPD diagnosis in hospitalised patients. Material and methods: Retrospective multicentre cross-sectional audit review of the clinical histories of patients discharged with a diagnosis of COPD. The diagnosis of COPD was considered correct (DxC) in cases where the combination of a bronchial obstruction (FEV1/FVC < 70%) and smoking ( > 10 packets/year) could be documented. In the rest of the cases the diagnosis was considered deficient (DxD). A DxC in at least 60% of patients was required to be considered an acceptable quality health care diagnosis. Demographic data such as, smoking, spirometry, the specialist who discharged the patient (P: Pneumologist; MS: Medical Specialty; CS: Surgical Specialty), and health care level (hospital complexity: low (HI), intermediate (H2) and high (H3)). Results: A total of 840 cases were analysed (718 males, 122 females); mean age (SD) 73 (10), from 10 hospitals (3 H1, 4 H2, 3 H3). A DxD was obtained in 597 (71.1%), due to either lack of spirometry (538, 64%) or smoking criteria (319, 38%), (P < 0.001). Only two of the ten hospitals complied with the criteria of an acceptable quality health care diagnosis. Significant differences (P < 0.0001) were seen on comparing DxC and DxD by health care level (DxC: 56.2% in HI, 29.9% in H2, 20.9% in H3), and by specialist (DxC: 47.6% en P, 24.6% in SP, 17.4% in MS). A multivariate analysis associated DxC with the male sex, H I and pneumology reports. Conclusions: 1. The quality health care for the diagnosis of COPD is deficient. 2. The lack of spirometry is the most common cause of DxD. (C) 2009 SEPAR. Published by Elsevier Espana, S.L. All rights reserved.

Filiaciones:
:
 Unidad de Neumología, Hospital Francesc de Borja, Gandía, Valencia, España.
ISSN: 03002896





ARCHIVOS DE BRONCONEUMOLOGIA
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ELSEVIER DOYMA SL, TRAVESERA DE GARCIA, 17-21, BARCELONA, 08021, SPAIN, España
Tipo de documento: Article
Volumen: 46 Número: 2
Páginas: 64-69
WOS Id: 000274890900003
ID de PubMed: 20353856

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