Abstract
Objective This epidemiological investigation aimed at determining the current situation regarding the diagnosis and treatment of chronic obstructive pulmonary disease (COPD), especially missed diagnosis and missed treatment, in a group of individuals residing in an island area of Ningbo. Methods Adults ≥60 years of age were selected from an island area of Ningbo. All participants completed a COPD-Screening Questionnaire and underwent a post-bronchodilator pulmonary function test. COPD-positive individuals then completed a questionnaire surveying the status of diagnosis and treatment of COPD and the reasons for missed diagnosis and treatment. The data were collated and analyzed using SPSS version 22.0 (IBM Corporation, Armonk, NY, USA). Findings (1) A total of 1526 individuals were screened, of whom 1371 (89.8%) were eventually included in data analysis. From these, 254 were diagnosed with spirometry-defined COPD, corresponding to an overall prevalence of 18.5%. Prevalence was higher in men (28.9%) than in women (8.3%) among the sample. (2) According to chi-squared test results, risk factors for COPD included sex, age, smoking history (pack-years), cough, and dyspnea. Body mass index, family history of respiratory diseases, and exposure to biomass smoke from cooking were not risk factors for COPD. (3) Multivariate logistic regression analysis revealed that age and smoking were independent risk factors for COPD. (4) Receiver operating curve analysis revealed that, at a cutoff of 19.5, the highest sum of sensitivity and specificity was 69.7% and 75.5%, respectively. The COPD-Screening Questionnaire could be used as a preselection method to screen for COPD in primary care settings. (5) Of 254 individuals diagnosed with COPD, only 10 had a history of COPD and only 35 had a previous diagnosis of pneumonia or bronchitis. These data revealed that the rate of missed diagnosis of COPD in the Ningbo island area was 96.1%. Conclusion The prevalence of COPD among elderly individuals in the Ningbo island area was significantly higher than in other parts of China. Moreover, the rate of missed diagnosis of COPD in the Ningbo island area was extremely high. Smoking and age were independent factors for the occurrence of COPD.
Highlights
Chronic obstructive pulmonary disease (COPD) is a disease characterized by limitations in reversible airflow
Family history of respiratory diseases, and exposure to biomass smoke from cooking were not risk factors for COPD. (3) Multivariate logistic regression analysis revealed that age and smoking were independent risk factors for COPD. (4) Receiver operating curve analysis revealed that, at a cutoff of 19.5, the highest sum of sensitivity and specificity was 69.7% and 75.5%, respectively. e COPD-Screening Questionnaire could be used as a preselection method to screen for COPD in primary care settings
(5) Of 254 individuals diagnosed with COPD, only 10 had a history of COPD and only 35 had a previous diagnosis of pneumonia or bronchitis. ese data revealed that the rate of missed diagnosis of COPD in the Ningbo island area was 96.1%
Summary
Chronic obstructive pulmonary disease (COPD) is a disease characterized by limitations in reversible airflow. E Global Burden of Disease study estimated that 174.5 million adults were affected by COPD, with a disease burden of 384 million in 2015. It was estimated that 3.2 million individuals died of COPD that year [2, 3]. E China Pulmonary Health (CPH) study [5] reported that the prevalence of COPD was 8.6% in individuals ≥20 years of age, corresponding to approximately 99.9 million Chinese adults. Ere have been few epidemiological investigations of COPD in island areas domestically and abroad, and investigations examining the prevalence and missed diagnosis of COPD in individuals ≥60 years of age are relatively insufficient. Erefore, we aimed to estimate the prevalence of COPD in the Ningbo island area among individuals ≥60 years of age, as well as its rate of diagnosis and treatment. We gathered and assessed risk factors relevant to COPD and the level of awareness of the disease
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