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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Chronic obstructive pulmonary disease &#40;COPD&#41; is a common disease&#44; the early diagnosis of which allows effective management and treatment&#46; The aim of the present study is to show the effectiveness of a screening and monitoring plan for COPD in high-risk patients in primary health care&#46;</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p class="elsevierStyleSimplePara elsevierViewall">The subjects in this prospective observational longitudinal study comprised 164 high-risk smokers aged between 40 and 76 years&#46; Age&#44; sex&#44; weight&#44; height&#44; and smoking habit &#40;pack-years&#41; were recorded and spirometry was performed according to the guidelines of the Spanish Society of Pulmonology and Thoracic Surgery &#40;SEPAR&#41;&#46; Patients were informed of their results and given brief advice on how to stop smoking&#46; After 3 years&#44; the patients underwent the same evaluation&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">In 1999&#44; 22&#37; of the smokers were diagnosed with COPD&#46; Three years later&#44; an additional 16&#46;3&#37; were diagnosed as having COPD&#44; and the disease had worsened in 38&#46;8&#37; of those already diagnosed&#46; Of the patients with a forced expiratory volume in one second &#40;FEV<span class="elsevierStyleInf">1</span>&#41; less than 90&#37;&#44; 44&#46;8&#37; developed COPD &#40;relative risk&#58; 10&#46;54&#41;&#46; An accelerated decrease in FEV<span class="elsevierStyleInf">1</span> was found in 18&#46;1&#37; of the patients &#40;20&#46;7&#37; with COPD and 9&#46;0&#37; without COPD&#41;&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Mean tobacco consumption in 1999 was 28&#46;1 pack-years in subjects without COPD and 31&#46;7 pack-years in those with COPD&#44; whereas in 2002&#44; consumption was 30&#46;6 pack-years in patients with COPD and 31&#46;9 pack-years in those without&#46; In 3 years&#44; 22&#46;8&#37; had stopped smoking &#40;20&#46;5&#37; without COPD and 30&#46;3&#37; with COPD&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Many smokers managed to give up smoking after learning their spirometric results&#46; FEV<span class="elsevierStyleInf">1</span> can identify smokers at greatest risk of developing COPD&#46; Spirometric screening and monitoring of smokers at high risk in primary health care can identify those most susceptible to developing COPD while the disease is in an early phase&#46; Therefore the most appropriate strategy can be adopted for each patient&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">La enfermedad pulmonar obstructiva cr&#243;nica &#40;EPOC&#41; es una patolog&#237;a prevalente&#44; cuyo diagn&#243;stico tem-prano permite adoptar medidas de control y tratamiento&#46; El objetivo del presente estudio es mostrar la efectividad de un plan de cribado y seguimiento de la EPOC en pacientes de alto riesgo desde atenci&#243;n primaria&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se trata de un estudio observacio-nal longitudinal y prospectivo&#46; La poblaci&#243;n de estudio la componen 164 fumadores de alto riesgo de entre 40 y 76 a&#241;os de edad&#46; Se estudiaron las variables edad&#44; sexo&#44; peso&#44; altura y h&#225;bito tab&#225;quico &#40;paquetes&#47;a&#241;o&#41; y se realiz&#243; una espirometr&#237;a seg&#250;n la normativa de la Sociedad Espa&#241;ola de Neumolog&#237;a y Cirug&#237;a Tor&#225;cica &#40;SEPAR&#41;&#46; Se inform&#243; de los resultados a los pacientes y se les dio consejo breve para de-jar de fumar&#46; A los 3 a&#241;os se llev&#243; a cabo una reevaluaci&#243;n con los mismos criterios&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">En 1999 el 22&#37; de los fumadores presentaron criterios de EPOC&#46; Al cabo de 3 a&#241;os se detect&#243; un 16&#44;3&#37; de casos nuevos y el 38&#44;8&#37; de los ya diagnosticados empeoraron&#46; El 44&#44;8&#37; de los pacientes con volumen espiratorio forzado en el primer segundo inferior al 90&#37; evolucion&#243; a EPOC &#40;riesgo relativo&#58; 10&#44;54&#41;&#46; El 18&#44;1&#37; de los pacientes present&#243; p&#233;rdida acelerada del volumen espiratorio forzado en el primer segundo &#40;FEV<span class="elsevierStyleInf">1</span>&#41; &#40;el 20&#44;7&#37; sin EPOC y un 9&#44;0&#37; con EPOC&#41;&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">El consumo de tabaco en 1999 fue de 28&#44;1 paquetes&#47;a&#241;o de media en individuos sin EPOC y de 31&#44;7 paquetes&#47;a&#241;o en los pacientes con EPOC&#46; En el a&#241;o 2002 el consumo fue de 30&#44;6 y 31&#44;9 paquetes&#47;a&#241;o&#44; respectivamente&#46; En el intervalo de 3 a&#241;os dej&#243; de fumar el 22&#44;8&#37; de los individuos &#40;el 20&#44;5&#37; sin EPOC y el 30&#44;3&#37; con EPOC&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Un n&#250;mero considerable de fumadores consigue abandonar el h&#225;bito de fumar tras conocer sus resultados espirom&#233;tricos&#46; El FEV<span class="elsevierStyleInf">1</span> tiene una buena capacidad predictiva para identificar a los fumadores con mayor riesgo de evolucionar a EPOC&#46; El cribado y el seguimiento&#44; me-diante espirometr&#237;a&#44; de fumadores de alto riesgo en atenci&#243;n primaria permite identificar a los m&#225;s susceptibles de evolucionar a EPOC en una fase temprana y as&#237; establecer la es-trategia de abordaje m&#225;s adecuada para cada paciente&#46;</p>"
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Vol. 40. Issue 4.
Pages 155-159 (April 2004)
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Vol. 40. Issue 4.
Pages 155-159 (April 2004)
Original Articles
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Spirometry Is a Good Method for Detecting and Monitoring Chronic Obstructive Pulmonary Disease in High-Risk Smokers in Primary Health Care
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J. Cloteta,b,
Corresponding author
jclotets@meditex.es

Correspondence: Dr. J. Clotet. Centro de Atención Primaria de Ponts. Ctra. de Lleida, 3. 25740 Ponts. Lleida. España
, X. Gómez-Arbonésb, C. Ciriaa, J.M. Albalada
a Centro de Atención Primaria de Ponts, Ponts, Lleida, Spain
b Departamento de Medicina, Universitat de Lleida, Lleida, Spain
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Article information
Objective

Chronic obstructive pulmonary disease (COPD) is a common disease, the early diagnosis of which allows effective management and treatment. The aim of the present study is to show the effectiveness of a screening and monitoring plan for COPD in high-risk patients in primary health care.

Patients and method

The subjects in this prospective observational longitudinal study comprised 164 high-risk smokers aged between 40 and 76 years. Age, sex, weight, height, and smoking habit (pack-years) were recorded and spirometry was performed according to the guidelines of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR). Patients were informed of their results and given brief advice on how to stop smoking. After 3 years, the patients underwent the same evaluation.

Results

In 1999, 22% of the smokers were diagnosed with COPD. Three years later, an additional 16.3% were diagnosed as having COPD, and the disease had worsened in 38.8% of those already diagnosed. Of the patients with a forced expiratory volume in one second (FEV1) less than 90%, 44.8% developed COPD (relative risk: 10.54). An accelerated decrease in FEV1 was found in 18.1% of the patients (20.7% with COPD and 9.0% without COPD).

Mean tobacco consumption in 1999 was 28.1 pack-years in subjects without COPD and 31.7 pack-years in those with COPD, whereas in 2002, consumption was 30.6 pack-years in patients with COPD and 31.9 pack-years in those without. In 3 years, 22.8% had stopped smoking (20.5% without COPD and 30.3% with COPD).

Conclusions

Many smokers managed to give up smoking after learning their spirometric results. FEV1 can identify smokers at greatest risk of developing COPD. Spirometric screening and monitoring of smokers at high risk in primary health care can identify those most susceptible to developing COPD while the disease is in an early phase. Therefore the most appropriate strategy can be adopted for each patient.

Key words:
Susceptible smokers
Chronic obstructive pulmonary disease
High-risk group
Spirometry
Objetivo

La enfermedad pulmonar obstructiva crónica (EPOC) es una patología prevalente, cuyo diagnóstico tem-prano permite adoptar medidas de control y tratamiento. El objetivo del presente estudio es mostrar la efectividad de un plan de cribado y seguimiento de la EPOC en pacientes de alto riesgo desde atención primaria.

Pacientes y métodos

Se trata de un estudio observacio-nal longitudinal y prospectivo. La población de estudio la componen 164 fumadores de alto riesgo de entre 40 y 76 años de edad. Se estudiaron las variables edad, sexo, peso, altura y hábito tabáquico (paquetes/año) y se realizó una espirometría según la normativa de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR). Se informó de los resultados a los pacientes y se les dio consejo breve para de-jar de fumar. A los 3 años se llevó a cabo una reevaluación con los mismos criterios.

Resultados

En 1999 el 22% de los fumadores presentaron criterios de EPOC. Al cabo de 3 años se detectó un 16,3% de casos nuevos y el 38,8% de los ya diagnosticados empeoraron. El 44,8% de los pacientes con volumen espiratorio forzado en el primer segundo inferior al 90% evolucionó a EPOC (riesgo relativo: 10,54). El 18,1% de los pacientes presentó pérdida acelerada del volumen espiratorio forzado en el primer segundo (FEV1) (el 20,7% sin EPOC y un 9,0% con EPOC).

El consumo de tabaco en 1999 fue de 28,1 paquetes/año de media en individuos sin EPOC y de 31,7 paquetes/año en los pacientes con EPOC. En el año 2002 el consumo fue de 30,6 y 31,9 paquetes/año, respectivamente. En el intervalo de 3 años dejó de fumar el 22,8% de los individuos (el 20,5% sin EPOC y el 30,3% con EPOC).

Conclusions

Un número considerable de fumadores consigue abandonar el hábito de fumar tras conocer sus resultados espirométricos. El FEV1 tiene una buena capacidad predictiva para identificar a los fumadores con mayor riesgo de evolucionar a EPOC. El cribado y el seguimiento, me-diante espirometría, de fumadores de alto riesgo en atención primaria permite identificar a los más susceptibles de evolucionar a EPOC en una fase temprana y así establecer la es-trategia de abordaje más adecuada para cada paciente.

Palabras clave:
Fumadores susceptibles
Enfermedad pulmonar obstructiva crónica
Grupo de alto riesgo
Espirometría
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Copyright © 2004. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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