Publication: Determinantes del infradiagnóstico de la enfermedad pulmonar obstructiva crónica
Loading...
Files
Official URL
Full text at PDC
Publication Date
2017-02-09
Authors
Advisors (or tutors)
Editors
Journal Title
Journal ISSN
Volume Title
Publisher
Universidad Complutense de Madrid
Citations
Exportar
Abstract
La enfermedad pulmonar obstructiva crónica (EPOC) es una enfermedad muy prevalente, que causa una gran morbimortalidad en el mundo y que es responsable de una importante carga económica y social. La Organización Mundial de la Salud (OMS) estimó en 1990 que 210 millones de personas padecían una EPOC (1). En España, el estudio EPISCAN, realizado en el 2007, mostró una prevalencia global de la EPOC del 10,2% (2). Una prevalencia que según el Global Burden of Disease Study (GBD) de 2010 ha ascendido, con un incremento que se ha estimado en un 1,1% (3). Este aumento en la prevalencia de la EPOC en nuestro medio depende fundamentalmente de dos factores: los efectos relacionados con la exposición tabáquica acumulada y el envejecimiento paulatino de la población. La EPOC es una enfermedad con un elevado impacto en salud pública, siendo motivo de numerosas consultas en atención primaria (más del 10% del total) y en el ámbito de la neumología (el 30% del total). Ocasiona, además, un elevado número de hospitalizaciones (10% de los ingresos por causa médica) y de fallecimientos (4). Actualmente representa la tercera causa de muerte en el mundo, situándose por detrás de la cardiopatía isquémica y del accidente cerebrovascular. La EPOC ascendió en el ranking mundial de mortalidad del cuarto puesto, en 1990, al tercero en 2010 (3). En España, la tasa de mortalidad por EPOC (muertes/por 100.000 habitantes), ajustada por población mundial fue, en el año 2008, de 449,22 en los hombres y 238,47 en las mujeres, con un aumento significativo de esta tasa a partir de los 55 años, sobre todo en los hombres. No obstante, pese a la elevada mortalidad de la EPOC, durante la última década se ha evidenciado una tendencia a disminuir, tanto en los hombres como en las mujeres, al comparar las tasas ajustadas por población mundial (5)...
The chronic obstructive pulmonary disease (COPD) is a highly prevalent disease and an important cause of worldwide morbidity and mortality which is responsible for a great economical and social burden. According to the World Health Organization (WHO), in 1990 some 210 million people worldwide suffered from COPD. In Spain, the EPI-SCAN survey conducted in 2007 revealed a global COPD prevalence of 10,2%. A prevalence which has increased an estimated 1,1% according to the Global Burden of Disease Study (GBD) of 2010. This increase in COPD prevalence in our country depends mainly on two factors: the cumulative exposure to tobacco smoke and the gradual aging of the population. COPD is an important public health issue and the reason for numerous primary care visits (more than 10% of their total number) and pulmonology visits (a 30% of total). Moreover, it causes a great number of hospital admissions (a 10% of medical admissions) and deaths. It is the third leading cause of death worldwide following ischemic heart disease and stroke. Nevertheless, despite all the data of COPD being a very prevalent disease with an important morbidity and mortality, we know that it is largely under-diagnosed. This is confirmed by IBERPOC study conducted in Spain in 1997, which revealed a high level of under-diagnosis since 78.2% of spirometrically confirmed COPD were newly diagnosed. These results have been reproduced 10 years later in the EPI-SCAN survey which showed that COPD under-diagnosis in Spain has been only slightly reduced, from 78% to 73%. Besides the important COPD under-diagnosis, theses studies also revealed that the disease is diagnosed in advanced stages when a great percentage of patient's lung function has been already lost. This reality obviates the need to improve the diagnosis of COPD with a straightforward goal: to be able to change it's natural history and reduce it's complications and associated morbidity and mortality. A correct and early diagnosis will influence the disease evolution and reduce it's morbidity and mortality...
The chronic obstructive pulmonary disease (COPD) is a highly prevalent disease and an important cause of worldwide morbidity and mortality which is responsible for a great economical and social burden. According to the World Health Organization (WHO), in 1990 some 210 million people worldwide suffered from COPD. In Spain, the EPI-SCAN survey conducted in 2007 revealed a global COPD prevalence of 10,2%. A prevalence which has increased an estimated 1,1% according to the Global Burden of Disease Study (GBD) of 2010. This increase in COPD prevalence in our country depends mainly on two factors: the cumulative exposure to tobacco smoke and the gradual aging of the population. COPD is an important public health issue and the reason for numerous primary care visits (more than 10% of their total number) and pulmonology visits (a 30% of total). Moreover, it causes a great number of hospital admissions (a 10% of medical admissions) and deaths. It is the third leading cause of death worldwide following ischemic heart disease and stroke. Nevertheless, despite all the data of COPD being a very prevalent disease with an important morbidity and mortality, we know that it is largely under-diagnosed. This is confirmed by IBERPOC study conducted in Spain in 1997, which revealed a high level of under-diagnosis since 78.2% of spirometrically confirmed COPD were newly diagnosed. These results have been reproduced 10 years later in the EPI-SCAN survey which showed that COPD under-diagnosis in Spain has been only slightly reduced, from 78% to 73%. Besides the important COPD under-diagnosis, theses studies also revealed that the disease is diagnosed in advanced stages when a great percentage of patient's lung function has been already lost. This reality obviates the need to improve the diagnosis of COPD with a straightforward goal: to be able to change it's natural history and reduce it's complications and associated morbidity and mortality. A correct and early diagnosis will influence the disease evolution and reduce it's morbidity and mortality...
Description
Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 09-09-2015