COPD has long latent period before manifesting clinically. India has high smoking population but available data mostly based on clinical assessment shows prevalence of 5%, 2.7% in males and females respectively which are far lower than in countries where spirometry is routinely used. Thus the present study was planned to assess the role of spirometry in its early detection.
One hundred subjects undiagnosed for COPD having smoking history of at least 15 pack years were assessed for their symptoms and signs. Spirometry was then performed. COPD diagnosis and staging was done according to GOLD Guidelines. The relationship of variables: age, pack years, exposure to dust or chemicals and respiratory manifestations to presence or absence of COPD was assessed.
COPD was diagnosed in 13% of subjects. Significantly restriction was also found in another 6%. In our study the chances of developing COPD increased with age, lesser age of starting smoking, presence of coexistent exposure to dust or chemicals (each having p < 0.05) while no significant relation was observed between pack years or smoking device being used to COPD. 90% of COPD patients were found to have any one of cough or breathlessness or their combination but it was a non specific finding reported in 62% of non COPD patients also. The finding of barrel chest, hyperresonant note and diminished breath sounds were found to be usually associated with advanced disease.
The study shows that spirometric screening of smokers is a useful tool to detect COPD in early stages in high risk subjects.
Detection of COPD when clinically asymptomatic and subsequent life style modification in those having early spirometric abnormalities can prevent or delay the disease becoming clinically manifest. Thus the morbidity, mortality and the high financial implications of the late stages of disease can be prevented.
Nirmal Chand, No Financial Disclosure Information; No Product/Research Disclosure Information