Pulmonary function grading and comprehensive assessment in patients with chronic obstructive pulmonary disease
LU Feng, CHEN Xiangyu, ZHAO Ming, ZHANG Jie, ZHONG Jieming, HU Ruying
Department of Noncommunicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang 310051, China
Abstract：Objective To understand the characteristics of different pulmonary function grades and comprehensive assessment groups among patients with chronic obstructive pulmonary disease (COPD) from community survey, so as to provide the evidence for the comprehensive community management of COPD. Methods The survey data of five monitoring sites in Zhejiang Province during 2014-2015 in the COPD surveillance of Chinese residents aged 40 years and above was collected. The patients with COPD were classified by pulmonary function according to the percentage of forced expiratory volume in the first second (FEV1) in the predicted value, and by comprehensive assessment according to modified British Medical Research Council (mMRC) score, COPD Assessment Test (CAT) score and acute exacerbation in the past year. The characteristics of different pulmonary function grading and comprehensive assessment groups were compared. Results A total of 355 patients with COPD were found, with an average age of (63.00±9.63) years. The male-to-female ratio was 3.18:1. There were 243 patients with an education level of primary school or below, accounting for 68.45%. The awareness rate of COPD related knowledge was only 1.69%. There were 257 (72.39%) patients with mild, 86 (24.23%) patients with moderate, and 12 (3.38%) patients with severe pulmonary function. The proportions of patients with childhood history of severe respiratory infection, self-reported respiratory system diseases, chronic cough, chronic sputum, acute exacerbation in the past year, CAT score ≥10 points, and inhaled medication were lower in the patients with mild pulmonary function than with moderate and severe pulmonary function; the body mass index and waist circumference were higher in the patients with mild pulmonary function than in the patients with moderate and severe pulmonary function (all P<0.05). The comprehensive assessment resulted in 158 (44.51%) patients of Group A, 134 (37.75%) patients of Group B, 1 (0.28%) patient of Group C, and 7 (1.97%) patients of Group D. The average age and systolic pressure were lower in Group A than in Group B, C and D; the proportions of patients with self-reported respiratory system diseases, family history of respiratory diseases, chronic cough, chronic sputum, dyspnea, acute exacerbation in the past year and CAT score ≥10 points were lower in Group A than in Group B, C and D (all P<0.05). Conclusion The community patients with COPD are mainly classified to mild pulmonary function and Group A in the comprehensive assessment; thus they need different levels of management.
