title: COPD: an underdiagnosed disease at hospital environment.
abstract: OBJECTIVE
  Chronic obstructive pulmonary disease (COPD) is a serious disease with morbidity and mortality due to delayed diagnosis until significant symptoms arise. We aimed to assess the utility of spirometry and COPD Assessment Test (CAT) in detecting undiagnosed COPD patients in a localized area.
  
  
  METHODS
  People who came to the hospital for patient visit or examination with a smoking history of > 10 pack-years (> 40 years old), and with no known chest disease were invited to study. The participants completed a questionnaire and performed spirometry. Spirometry was performed according to ATS/ERS Task Force on spirometry. COPD was defined as according to the Global Initiative for Chronic Obstructive Lung Disease guidelines.
  
  
  RESULTS
  There were 800 subjects screened, and 648, capable of performing spirometry, were included to the study. The mean age was 48.3 ± 9.0 and 38 % of the study population was male. Post-bronchodilator FEV1/FVC ratio was lower than 0.70 in 17 % of the subjects. Median (25-75 percentiles) total CAT scores and among the questions of CAT; cough, phlegm, chest tightness and breathlessness scores for COPD and non-COPD subjects were; 15(9-22) vs 12(6-18) (p  = .004), 2(1-3) vs 1(0-2) (p  < .001), 2(0-3) vs 1(0-3) (p  = .004), 3(1-4) vs 2(0-3) (p  > .001), 4(3-5) vs 3(2-4) (p  = .001), respectively. Symptom prevalence was as follows: exertional dyspnea 91 %, dyspnea 80.9 %, cough 56.3 % and phlegm 58.3 % in COPD.
  
  
  CONCLUSIONS
  Our study showed that spirometric screening together with the CAT questionnaire may improve the awareness of disease and may determine undiagnosed patients.
authors.affiliation: Department of Pulmonary Medicine, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Kart
authors.forename: Muhammed Emin
authors.initials: ME
authors.lastname: Akkoyunlu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Bayram
authors.forename: Fatih
authors.initials: F
authors.lastname: Yakar
authors.forename: Hatice
authors.initials: H
authors.lastname: Kutbay Özçelik
authors.forename: Fatmanur
authors.initials: F
authors.lastname: Karaköse
authors.forename: Murat
authors.initials: M
authors.lastname: Sezer
mesh_terms: D015897:Comorbidity; D003371:Cough / Q000453:epidemiology*; D004417:Dyspnea / Q000453:epidemiology*; D004522:Educational Status; D004651:Employment; D005188:False Negative Reactions; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000453:epidemiology*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012907:Smoking / Q000453:epidemiology*; D013147:Spirometry / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014421:Turkey / Q000453:epidemiology