低诊断和过度诊断慢性阻塞性肺病与所有原因死亡率之间的关联
Suyin Huang1,2, Juncheng Liang3, Zhishan Deng1
1National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
低诊断和过度诊断的慢性阻塞性肺病 (COPD) 与死亡率的增加有关. 螺旋测量可以帮助标准化COPD诊断,减少误诊率,改善患者的治疗结果.
科学领域:
- 肺部医学 肺部医学
- 流行病学 流行病学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 慢性阻塞性肺病 (COPD) 的诊断往往是不准确的,导致诊断不足或过度诊断.
- 关于与一般人群中这些诊断错误相关的长期健康结果的数据有限.
研究的目的:
- 调查低诊断和过度诊断的COPD与全因死亡率之间的关联.
- 分析错误诊断的COPD患者的并发症和呼吸系统症状的风险.
主要方法:
- 对NHANES数据 (1988-1994,2007-2012) 进行回顾性分析,并进行螺旋计和死亡率后续检查.
- 参与者被分为非COPD,低诊断的COPD,过度诊断的COPD和确诊的COPD组.
- 用于评估并发病,症状和死亡风险的物流和考克斯回归模型.
主要成果:
- 过度诊断的COPD与伴随疾病和呼吸系统症状的风险更高有关.
- 未确诊的COPD与慢性呼吸道症状的可能性增加有关.
- 低诊断 (HR: 1.25) 和过度诊断 (HR: 1.18) 的COPD组与非COPD个体相比,所有原因的死亡率显著更高.
结论:
- 低诊断和过度诊断导致COPD增加疾病负担和死亡率.
- 螺旋测量对于准确的COPD诊断至关重要,可能减少误诊.
- 在没有螺旋计的资源有限的环境中,建议基于潜在病因学的早期干预.
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