DIAGNOSTICS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN REAL CLINICAL PRACTICE: HYPODIAGNISTICS OR HYPERDIAGNOSTICS

Abstract

According to the data of the world statistics there is observed the continuous growth of chronic obstructive pulmonary disease (COPD). According to the last data of the World health organization (WHO), for today there is near 250 mln persons with chronic obstructive pulmonary disease (COPD), and this disease becomes as cause of death of near 3 mln persons annually. Aim: to establish the prevalence of undiagnosed chronic pulmonary disease (COPD) among persons, who consider themselves as healthy ones and regularly undergo medical check-ups; to estimate the frequency of chronic obstructive pulmonary disease (COPD) according to the data of medical documentation. Methods and materials: 525 persons, older than 35, who did not have in an anamnesis any chronic diseases of respiratory tract, were interrogated. At the following stage, persons, who had taken 18 points or more underwent a spirography with bronchodilatation test, using 400 mcg of salbutamol and were interrogated by the modified questionnaire of short breath by the medical research council (MRC) and test of the chronic obstructive pulmonary disease estimation (COPD) (TEC). There were examined 136 patients, mean age (51,5±0,8), men were 81(59,5 %) mean age (52,2±1,1) and women – 55(40,4 %) mean age (50,7±0,9). There were analyzed 56 medical stories of patients, treated at therapeutic departments of the city clinic because of internal organs diseases with the concomitant diagnosis of chronic obstructive pulmonary disease (COPD). Among persons with first revealed chronic obstructive pulmonary disease у 21 (26,6 %) was reveled І severity degree according to GOLD, in 26 persons (32,9 %) – GOLD ІІ, in 28 (35,4 %) – GOLD ІІІ, in 4 (5,1 %) – GOLD ІV severity degree, so 32 patients did not receive basic treatment at all. At the same time among patients with COPD diagnosis in medical documentation only in 38,4 % this diagnosis was spirographically verified, the hyperdiagnostics of disease on the base of complaints and age characteristic took place in other cases.