Estimating the prevalence of phenotypes in patients with pulmonary obstructive disease. ADEPOCLE study

Abstract

Objective: To estimate the prevalence of chronic obstructive pulmonary disease (COPD) phenotypes in the province of Leon. Methods: Multicenter epidemiological cross-sectional study (30 health centers in the province of Leon). It included patients older than 35 years diagnosed and treated for COPD. Study variables: age, sex, habitat, anthropometric data, smoking, postbronchodilator spirometry, dyspnea (mMRC), exacerbations, severity (Bodex Index), hospitalization, treatment, monitoring and characterization of the phenotype (GesEOPC 2014). Results are expressed with CI 95.5%. Results: 833 patients were included. 85.8% male with an average age of 64.69 (53.66 to 75.61) and 20.65 years (4.47 to 36.8) years course of COPD. 86.67% (80.30 to 93.30) had smoked. Prevalence of phenotypes: 58.8% (55.2 to 61.9) not exacerbator, 13.6% (11.3 to 16.3) FMEA, 10.8% (8.8 to 13.3) exacerbator with emphysema and 16.7% (14.2 to 19.3) exacerbator with chronic bronchitis, p < 0.05. In the not exacerbator phenotype mild forms predominate and are controlled by general practitioner doctors. In the exacerbator phenotypes severe forms predominate and monitoring is shared by GP doctors and pulmonologists. Exacerbations are more common in exacerbator phenotypes with chronic bronchitis (40%), emphysema (27%) and FMEA (23%), p = 0.004. The exacerbator phenotype with chronic bronchitis have exacerbations an average of 6.4, 4 hospitalitations and 4 drugs prescribed/year. The exacerbator phenotype with emphysema have 5.7 exacerbations, 2.8 hospitalitations and 3.1 drugs prescribed/year. The FMEA have an average of 5 exacerbations, 1 hospitalitation and 2.6 prescribed drugs/year, p < 0.001. Conclusions: The clinical phenotypes are postulated as prognostic and therapeutic targets. Knowing its prevalence enables personalized treatment planning and better reallocation of resources for control and monitoring of COPD.