OBJECTIVES: To determine the prevalence and predictors of undiagnosed chronic obstructive pulmonary disease (COPD) in Norway. METHODS: An age and gender stratified random sample of all adults aged 47-48 and 71-73 years in Bergen, Norway, were invited. The 3506 participants filled in questionnaires including symptoms of COPD, smoking, socio-economic status, self-rated health and cardiac co-morbidity. Spirometry was performed before and after inhalation of 400 microg of salbutamol. COPD was defined as post-bronchodilator forced expiratory volume in 1 s (FEV1) / forced vital capacity (FVC) < 0.7 whereas diagnosed COPD was defined as having received treatment for obstructive lung disease the last year. RESULTS: Three hundred-three persons (9%) were classified as having COPD, and the undiagnosed fraction was 66%. In multiple logistic regression analysis, including multiple imputation, predictors of undiagnosed COPD were absence of COPD symptoms [odds ratio (OR) 6.92, P = 0.001], and self-report of being in good/excellent health (OR 2.39, P = 0.005). When post-bronchodilator FEV1 was added to the analysis, undiagnosed disease was predicted by pack years [OR 1.21 (1.01-1.47) per 10 pack-year increase, P = 0.043], and close to normal lung function [OR 1.48 (1.22-1.80) per 10% increase in post-bronchodilator FEV1 % predicted, P < 0.001]. Anthropometrical variables, socio-economic status and cardiac co-morbidity were not associated with having undiagnosed COPD. CONCLUSION: Two out of three COPD patients in Norway are undiagnosed. Risk factors for being undiagnosed are moderate reduction in lung function, absence of COPD symptoms and self-report of being in good health.
OBJECTIVES: To determine the prevalence and predictors of undiagnosed chronic obstructive pulmonary disease (COPD) in Norway. METHODS: An age and gender stratified random sample of all adults aged 47-48 and 71-73 years in Bergen, Norway, were invited. The 3506 participants filled in questionnaires including symptoms of COPD, smoking, socio-economic status, self-rated health and cardiac co-morbidity. Spirometry was performed before and after inhalation of 400 microg of salbutamol. COPD was defined as post-bronchodilator forced expiratory volume in 1 s (FEV1) / forced vital capacity (FVC) < 0.7 whereas diagnosed COPD was defined as having received treatment for obstructive lung disease the last year. RESULTS: Three hundred-three persons (9%) were classified as having COPD, and the undiagnosed fraction was 66%. In multiple logistic regression analysis, including multiple imputation, predictors of undiagnosed COPD were absence of COPD symptoms [odds ratio (OR) 6.92, P = 0.001], and self-report of being in good/excellent health (OR 2.39, P = 0.005). When post-bronchodilator FEV1 was added to the analysis, undiagnosed disease was predicted by pack years [OR 1.21 (1.01-1.47) per 10 pack-year increase, P = 0.043], and close to normal lung function [OR 1.48 (1.22-1.80) per 10% increase in post-bronchodilator FEV1 % predicted, P < 0.001]. Anthropometrical variables, socio-economic status and cardiac co-morbidity were not associated with having undiagnosed COPD. CONCLUSION: Two out of three COPDpatients in Norway are undiagnosed. Risk factors for being undiagnosed are moderate reduction in lung function, absence of COPD symptoms and self-report of being in good health.
Authors: Aaron M Mulhall; Laura A Lach; Sara M Krzywkowski-Mohn; Jeffrey A Welge; Ralph J Panos Journal: Respir Med Date: 2013-07-01 Impact factor: 3.415
Authors: Gundula Behrens; Charles E Matthews; Steven C Moore; Albert R Hollenbeck; Michael F Leitzmann Journal: CMAJ Date: 2014-07-07 Impact factor: 8.262
Authors: MeiLan K Han; Anna W Steenrod; Elizabeth D Bacci; Nancy K Leidy; David M Mannino; Byron M Thomashow; R G Barr; Barry J Make; Russ P Bowler; Stephen I Rennard; Julia F Houfek; Barbara P Yawn; Catherine A Meldrum; John W Walsh; Fernando J Martinez Journal: Chronic Obstr Pulm Dis Date: 2015