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[Asthma-chronic obstructive pulmonary disease overlap syndrome: clinical-functional profile]
José Luis Che-Morales1, Jorge Valle-Piña, Jaber Carrillo-Chan
1Instituto Mexicano del Seguro Social, Unidad Médica de Atención Ambulatoria No. 1, Departamento de Neumología e Inhaloterapia. Mérida, Yucatán, México.
Background:
Asthma and Chronic Obstructive Pulmonary Disease (COPD) affects 1 in 10 individuals worldwide. Asthma and COPD overlap syndrome (ACOS) have more symptoms, exacerbations and worse pulmonary function.
Objective:
To evaluate the clinical-functional profile with ACOS who are detected in a second level clinic.
Methods:
Retrospective study; 466 patients 18 years and older with COPD and asthma with acceptable spirometries were analyzed. ACOS definition proposed by Montes de Oca and colleagues was used. Patients were divided in three groups: Asthma, COPD and ACOS. Differences were estimated with Chi square and ANOVA with Bonferroni´s adjustment.
Results:
79.1% were diagnosed with asthma, 8.1% COPD and 12.6% ACOS. ACOS patients were more symptomatic; the exacerbation frequency during the last year was greater (Asthma: 24.9% vs. COPD: 15.8% vs. ACOS: 39%; p=0.036); in patients with ACOS the magnitude of change in pulmonary function was greater than those with asthma (p=0.000). The severity of obstruction was worse among those patients with COPD and ACOS. Having medical diagnosis of ACOS, dyspnea mMRC >2 and ACT <15 increased the probability of exacerbation during last the year.
Conclusion:
The prevalence of ACOS was 12.6% in our group. The patients with ACOS had the worst disease control, more frequency of previous exacerbations and more severity in lung function.
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