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Original Research: COPD |

Frequency of Self-Reported COPD Exacerbation and Airflow Obstruction in Five Latin American Cities: The Proyecto Latinoamericano de Investigación en Obstrucción Pulmonar (PLATINO) Study

Maria Montes de Oca, MD; Carlos Tálamo, MD, FCCP; Ronald J. Halbert, MD; Rogelio Perez-Padilla, MD; Maria Victorina Lopez, MD; Adriana Muiño, MD; José Roberto B. Jardim, MD; Gonzalo Valdivia, MD; Julio Pertuzé, MD; Dolores Moreno, MD; Ana Maria B. Menezes, MD
Author and Funding Information

From the Servicio de Neumonología (Drs. Montes de Oca, Tálamo, and Moreno), Hospital Universitario de Caracas, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela; UCLA School of Public Health (Dr. Halbert), Los Angeles, CA; Institute of Respiratory Diseases (Dr. Perez- Padilla), Mexico City, Mexico; Facultad de Medicina (Drs. Lopez and Muiño), Universidad de la República, Hospital Maciel, Montevideo, Uruguay; Federal University of São Paulo (Dr. Jardim), Sâo Paulo, Brazil; Departamento de Salud Publica (Dr. Valdivia), and Catedra de Neumologia (Dr. Pertuzé), Facultad de Medicina, Pontifícia Universidad Católica de Chile, Santiago de Chile, Chile; and Faculdade de Medicina (Dr. Menezes), Universidade Federal de Pelotas, Pelotas, RS, Brazil.

Correspondence to: María Montes de Oca, Universidad Central de Venezuela, Catedra de Neumonología, Hospital Universitario de Caracas, Piso 8, Ciudad Universitaria Caracas DC 1050, Venezuela; e-mail: mmdeoca@cantv.net

*Members of the PLATINO team are listed in the Appendix.


The Proyecto Latinoamericano de Investigación en Obstrucción Pulmonar (PLATINO) Study was funded by Boehringer Ingelheim GmbH. The funding source had no influence on the analyses or interpretation of the results presented in this article.

Dr. Halbert has received honorarium from Boehringer Ingelheim GmbH. Drs. Montes de Oca, Tálamo, Perez-Padilla, Lopez, Muiño, Jardim, Valdivia, Pertuzé, Moreno, and Menezes have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;136(1):71-78. doi:10.1378/chest.08-2081
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Background:  Recurrent exacerbations are common in COPD patients. Limited information exists regarding exacerbation frequency in COPD patients from epidemiologic studies. We examined the frequency of self-reported exacerbations and the factors influencing exacerbation frequency among COPD patients in a population-based study conducted in Latin America.

Methods:  We used a post-bronchodilator FEV1/FVC ratio of < 0.70 to define COPD. Exacerbation was self-reported and defined by symptoms (deterioration of breathing symptoms that affected usual daily activities or caused missed work).

Results:  Spirometry was performed in 5,314 subjects. There were 759 subjects with airflow limitation; of these, 18.2% reported ever having had an exacerbation, 7.9% reported having an exacerbation, and 6.2% reported having an exacerbation requiring at least a doctor visit within the past year. The proportion of individuals with an exacerbation significantly increased by Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages, from 4.2% in stage 1 to 28.9% in stages 3 and 4. The self-reported exacerbation rate was 0.58 exacerbations per year. The rate of exacerbations requiring at least a doctor visit and length of stay in hospital due to exacerbations also increased as COPD severity progressed. The factors associated with having an exacerbation in the past year were dyspnea, prior asthma diagnosis, receiving any respiratory therapy, and disease severity of GOLD stages 3 and 4.

Conclusions:  The proportion of individuals with airflow limitation and self-reported exacerbation increases as the disease severity progresses. Dyspnea, prior asthma diagnosis, receiving any respiratory therapy, and more severe obstruction were significantly associated with having an exacerbation in the past year.

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