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Predictive value of lung function below normal range and respiratory symptoms for progression of COPD
  1. Mieke Albers (m.albers{at}hag.umcn.nl)
  1. University Medical Center, Dept. of General Practice, Netherlands
    1. Tjard Schermer (t.schermer{at}hag.umcn.nl)
    1. University Medical Center, Dept. of General Practice, Netherlands
      1. Yvonne Heijdra (y.heijdra{at}long.umcn.nl)
      1. University Medical Centre, Pulmonology, Netherlands
        1. Johan Molema (j.molema{at}ulc.umcn.nl)
        1. University Lung Centre Dekkerswald, Netherlands
          1. Reinier Akkermans (r.akkermans{at}kwazo.umcn.nl)
          1. University Medical Centre, Dept. General Practice, Netherlands
            1. Chris van Weel (c.vanweel{at}hag.umcn.nl)
            1. University Medical Centre, Dept. of General Practice, Netherlands

              Abstract

              Abstract Background: Chronic Obstructive Pulmonary Disease (COPD) is an insidiously starting disease. Early detection has high priority because of the possibility of early implementation of smoking cessation interventions. An evidence based model for case-finding of COPD is not yet available.

              Study Objective: To describe the early development of COPD, and to assess the predictive value of early signs (respiratory symptoms, lung function below normal range, reversibility).

              Design and Methods: In a prospective study, based in general practice, formerly undiagnosed subjects (n=464) were assessed at baseline and at year five for respiratory symptoms and pulmonary function. Odds ratio’s of early signs were calculated (adjusted for age, gender, packyears at baseline, and smoking behaviour during follow-up), and defined as possible indicators of disease progression.

              Results: Over a five year period, the percentage of subjects with obstruction increased from 7.5% (n=35) at baseline to 24.8% (n=115) at year five. Baseline presence of mild early signs and lung function below normal range were related to an increased risk to develop mild to moderate COPD {GOLD I; OR:1.87 (95% CI [1.22-2.87]), respectively GOLD II; OR:2.08 (95% CI [1.29- 3.37]) to 2.54 (95% CI [1.25-5.19])}at year five.

              Conclusion: Lung function below normal range and early respiratory signs predict the development and progression of COPD.

              • COPD
              • GOLD
              • lower limit of normal
              • obstruction
              • progression

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