Prevalence of Chronic Obstructive Pulmonary Disease in Cardiac Outpatient Clinics Using Questionnaire and Spirometry Screening

Ching-Yi Chen ； Kun-Chou Hsieh ； Shin-Yi Liang ； Yi-Ping Hsiang ； Yu-Feng Wei

《胸腔醫學》 35卷3期 (2020/09) Pp. 96-105

摘要

Background: Patients who have COPD may visit cardiac outpatient clinics due to having similar symptoms. We aimed to investigate whether a COPD diagnostic questionnaire (CDQ) and spirometry can facilitate the early detection of undiagnosed COPD in individuals who visit cardiac clinics. Methods: A voluntary screening for COPD was conducted for patients who visited the cardiac clinics of E-Da hospital. Subjects aged ≧35 years and who had at least 1 cardiovascular comorbidity were eligible for COPD screening with the CDQ and spirometry. COPD was defined as a ratio of forced expiratory volume in the first second/forced vital capacity less than 0.7 by spirometry. Clinical data, including the presence of COPD symptoms and questionnaire scores, were collected for analysis. Results: A total of 808 patients were enrolled in this study. Of these patients, 21 had a confirmed diagnosis of COPD. The prevalence of COPD was only 2.6% in the subjects who visited our cardiac clinics. Compared to the non-COPD group, more of the COPD group were aged ≧70 years and were ex-smokers, and had ≧2 COPD symptoms, higher COPD Assessment Test and CDQ scores, and a smoking history of more than 20 pack/years. The prevalence, sensitivity, and specificity among patients with a CDQ score ≧21.5 were 6.6%, 62%, and 76%, with a low positive predictive value of 7% and a high negative predictive value of 99%. Conclusion: The prevalence of COPD in patients visiting cardiac clinics was low in this study. A CDQ score ≧21.5 before spirometry screening was more effective for screening COPD in this population.

關鍵字

chronic obstructive pulmonary disease ； prevalence ； questionnaire ； screening ； spirometry