Health status perception and airflow obstruction in five Latin American cities: the PLATINO study.
BACKGROUND
COPD is a highly prevalent disease but underdiagnosed, undertreated and possibly under-recognized by patients. Limited information exists regarding patients' perception of COPD severity. We compared patients' general health status perception, degree of breathlessness and physical activity limitation with the severity of their respiratory condition measured by airway obstruction, in a population-based sample.


METHODS
We used postbronchodilator FEV(1)/FVC<0.70 to define COPD. Patients' perception of their general health status was derived from the question "in general you would say that your health is: excellent, very good, good, fair or poor?"


RESULTS
Spirometry was performed in 5314 subjects: an FEV(1)/FVC ratio below 0.70 was found in 759 subjects. In persons with COPD, general health status decreased with increasing GOLD stages. Over one-half of subjects with stage 2 and one third of those with stages 3 and 4 reported their health status as good to excellent. There was also a disparity between airway obstruction severity and breathlessness intensity. Although the more severe COPD stages were frequently associated with significant compromise of work and everyday activities, patients often tended to provide an optimistic self evaluation of their health status.


CONCLUSIONS
The discrepancy observed between general health status, dyspnea severity, physical activity limitation and airway obstruction most likely reflect patients' underperception of disease severity, emphasizing the need for improving case-finding measures and multi-component evaluation of COPD subjects.
Servicio de Neumonología, Piso 8, Hospital Universitario de Caracas, Los Chaguaramos, Universidad Central de Venezuela, Caracas, Venezuela. mmdeoca@cantv.net
Maria
M
Montes de Oca
Carlos
C
Tálamo
Ronald J
RJ
Halbert
Rogelio
R
Perez-Padilla
Maria Victorina
MV
Lopez
Adriana
A
Muiño
José Roberto B
JR
Jardim
Gonzalo
G
Valdivia
Julio
J
Pertuzé
Dolores
D
Moreno
Ana Maria B
AM
Menezes
D000402:Airway Obstruction / Q000175:diagnosis / Q000503:physiopathology*; D004417:Dyspnea / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D007843:Latin America; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology; D012307:Risk Factors; D012649:Self Concept; D012720:Severity of Illness Index; D013147:Spirometry; D011795:Surveys and Questionnaires; D014504:Urban Health