José Luis Izquierdo1, Diego Morena2, Yolanda González3, José Manuel Paredero4, Bernardino Pérez5, Desirée Graziani2, Matilde Gutiérrez6, José Miguel Rodríguez7. 1. Departamento de Medicina y Especialidades, Universidad de Alcalá, Madrid, España; Servicio de Neumología, Hospital Universitario de Guadalajara, Guadalajara, España. Electronic address: joseluis.izquierdoa@uah.es. 2. Servicio de Neumología, Hospital Universitario de Guadalajara, Guadalajara, España. 3. SAVANA, Madrid , España. 4. Servicio de Farmacia de Atención Primaria, GAI de Guadalajara, Guadalajara, España. 5. Servicio de Informática, Hospital Universitario de Guadalajara, Guadalajara, España. 6. Servicio de Contratación Administrativa, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España. 7. Departamento de Medicina y Especialidades, Universidad de Alcalá, Madrid, España; Servicio de Neumología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
Abstract
OBJECTIVE: The aim of this study was to evaluate the quality of diagnosis and treatment of COPD using Big Data methodology on the Savana Manager 2.1 clinical platform. MATERIALS AND METHODS: A total of 59,369 patients with a diagnosis of COPD were included from a population of 1,219,749 adults over 40 years of age. RESULTS: In total, 78% were men. Spirometry data were available for only 26,453 (43.5%) subjects. Disease severity was classified in 18,172 patients: 4,396 mild, 7,100 moderate, and 6,676 severe, although only 27%, 34%, and 28%, respectively, presented obstructive spirometry. The clinical management of COPD is mainly the responsibility of the primary care and pulmonology departments, while internal medicine and, to a lesser extent, geriatrics also participate. Drug treatment was based on bronchodilators and inhaled corticosteroids (ICS). A marked decline in the use of long-acting beta-2 agonists (LABA) in monotherapy and a slight reduction in ICS/LABA combinations, associated with a LAMA in 74% of cases, was observed. All-cause in-hospital mortality among the overall population was 5.6% compared to 1% of the general population older than 40 years. In total, 35% were admitted to hospital, with an average stay of 6.6 days and a rate of hospital mortality in this group of 10.74%. DISCUSSION: This study identifies the main features of an unselected COPD population and the major errors made in the management of the disease.
OBJECTIVE: The aim of this study was to evaluate the quality of diagnosis and treatment of COPD using Big Data methodology on the Savana Manager 2.1 clinical platform. MATERIALS AND METHODS: A total of 59,369 patients with a diagnosis of COPD were included from a population of 1,219,749 adults over 40 years of age. RESULTS: In total, 78% were men. Spirometry data were available for only 26,453 (43.5%) subjects. Disease severity was classified in 18,172 patients: 4,396 mild, 7,100 moderate, and 6,676 severe, although only 27%, 34%, and 28%, respectively, presented obstructive spirometry. The clinical management of COPD is mainly the responsibility of the primary care and pulmonology departments, while internal medicine and, to a lesser extent, geriatrics also participate. Drug treatment was based on bronchodilators and inhaled corticosteroids (ICS). A marked decline in the use of long-acting beta-2 agonists (LABA) in monotherapy and a slight reduction in ICS/LABA combinations, associated with a LAMA in 74% of cases, was observed. All-cause in-hospital mortality among the overall population was 5.6% compared to 1% of the general population older than 40 years. In total, 35% were admitted to hospital, with an average stay of 6.6 days and a rate of hospital mortality in this group of 10.74%. DISCUSSION: This study identifies the main features of an unselected COPD population and the major errors made in the management of the disease.
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