PURPOSE: COPD is slowly progressive disease but its progression can be averted by withdrawing exposure to noxious agents early. Often, patients seek advice late when they become dyspneic, but by then 50% ventilation is irreparably lost. Smoking cessation is most rewarding intervention at any stage of COPD, and would prevent alarming future predictions if harnessed adequately. COPD currently ranks 6th in global impact scale and is predicted to number 3 by 2020. Literature suggests that COPD could be detected early by spirometry. High prevalence, morbidity and cost prompt to identify such cases early to obviate advanced stages. Present study evaluated the role of spirometric screening in early detection of COPD in chronic smokers. No such study has been conducted in our country.
METHODS: The study was conducted in 400 subjects at Medical College Hospital, from April, 2003 to September, 2005. Smokers above 40 years with smoking index [SI] of more than 100 were motivated for participation after an Initial COPD awareness campaign enacted through mass media viz. articles in newspapers, radio and television interviews, posters in hospital complex etc. Cases harboring non COPD pulmonary diseases were excluded. Spirometry comprised estimation of FVC and FEV1 and FEV1 / FVC ratio. COPD was diagnosed and classified as per GOLD guidelines-2003.
RESULTS: Of 400, 15.2% were found confirmed COPD cases. Of these 3.2,11.4,54 and 31 % cases were having stage I, II, III and IV respectively. Additionally 26.2% cases were in ‘at risk stage’ for COPD. COPD incidence increased with advancing age and rising SI, but not affected by gender, urban/rural background, occupation etc. Symptoms like cough, expectoration, dyspnea and signs like emphysematous chest were strongly associated with the disease.
CONCLUSION: Screening by spirometry was found very useful in early detection of COPD among risk population and it is feasible also in general practice.
CLINICAL IMPLICATIONS: The preliminary data thus generated will contribute significantly towards concept of spirometric screening for early detection and prevention of COPD in India.
DISCLOSURE: Ashok Janmeja, None.