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. 2015 May-Jun;133(3):245-51.
doi: 10.1590/1516-3180.2015.9620902. Epub 2015 Jun 1.

Incidence of chronic obstructive pulmonary disease based on three spirometric diagnostic criteria in Sao Paulo, Brazil: a nine-year follow-up since the PLATINO prevalence study

Graciane Laender Moreira  1 , Mariana Rodrigues Gazzotti  2 , Beatriz Martins Manzano  1 , Oliver Nascimento  3 , Rogelio Perez-Padilla  4 , Ana Maria Baptista Menezes  5 , José Roberto Jardim  6
Affiliations

Incidence of chronic obstructive pulmonary disease based on three spirometric diagnostic criteria in Sao Paulo, Brazil: a nine-year follow-up since the PLATINO prevalence study

Graciane Laender Moreira et al. Sao Paulo Med J. 2015 May-Jun.

Abstract
in English, Portuguese

Context and objective: Chronic obstructive pulmonary disease (COPD) is a respiratory disease of high prevalence and socioeconomic impact worldwide. It affects approximately 16% of the population of São Paulo. The incidence of COPD is still unknown in Brazil. The aim of this study was to estimate new cases of COPD in a population-based sample in São Paulo, Brazil, using three different spirometric diagnostic criteria, and to assess the concordance between these criteria.

Design and setting: Prospective cohort study, in the city of São Paulo, Brazil.

Methods: A questionnaire was applied and anthropometry and pre and post-bronchodilator spirometry were performed on the same subjects as in the initial PLATINO study (2003) in São Paulo. Data from this follow-up study were added to the original database of the initial phase. Incident COPD cases refer to subjects who developed the disease in accordance with each spirometric criterion during the nine-year follow-up period. The Statistical Package for the Social Sciences, version 17.0 (SPSS Inc., Chicago, IL, USA) was used in the analysis and the significance level was set at P < 0.05.

Results: 613 subjects participated in the follow-up. New COPD cases ranged in frequency from 1.4% to 4.0%, depending on the diagnostic criterion used. The concordance between the criteria ranged from 35% to 60%.

Conclusion: The incidence of COPD after a nine-year follow-up was high, but varied according to the spirometric criterion used. The agreement between the criteria for identifying new cases of the disease ranged from 35% to 60%.

CONTEXTO E OBJETIVO:: A doença pulmonar obstrutiva crônica (DPOC) é uma enfermidade respiratória de alta prevalência e grande impacto socioeconômico no mundo e afeta aproximadamente 16% da população paulista. A incidência da DPOC ainda é desconhecida no Brasil. O objetivo deste estudo foi avaliar os novos casos de DPOC numa amostra de base populacional em São Paulo, Brasil, considerando três diferentes critérios diagnósticos espirométricos, e avaliar a concordância entre esses critérios.

TIPO DE ESTUDO E LOCAL:: Estudo de coorte prospectivo, na cidade de São Paulo, Brasil.

MÉTODOS:: Foi aplicado um questionário e realizadas a antropometria e espirometria pré e pós-broncodilatador nos mesmos indivíduos do Estudo PLATINO inicial (2003), de São Paulo. Dados deste estudo de seguimento foram adicionados ao banco de dados original da fase inicial. Os casos incidentes da DPOC se referem aos indivíduos que desenvolveram a doença de acordo com cada critério espirométrico durante os nove anos de seguimento. Foi utilizado o programa Statistical Package for the Social Sciences, version 17.0 (SPSS Inc., Chicago, IL, USA) na análise e o nível de significância foi P < 0.05.

RESULTADOS:: Participaram do seguimento 613 indivíduos. Os novos casos de DPOC variaram de 1,4% a 4,0%, dependendo do critério diagnóstico utilizado, e a concordância entre os critérios para identificar os casos incidentes variou de 35% a 60%.

CONCLUSÃO:: A incidência da DPOC após nove anos de seguimento foi alta, porém variável de acordo com o critério espirométrico utilizado. A concordância entre os critérios para identificar os novos casos da doença variou de 35% a 60%.

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Conflict of interest statement

Conflict of interest: None

Figures

Figure 1.
Figure 1.. Flowchart for final sample in follow-up PLATINO study, São Paulo, Brazil.
Table 1.
Table 1.. Clinical, anthropometric and functional characteristics of initial PLATINO participants (n = 1,000) and follow-up PLATINO participants (n = 613)
Table 2.
Table 2.. Incident cases of chronic obstructive pulmonary disease (COPD) in São Paulo, Brazil, based on three different spirometric diagnostic criteria
Figure 2.
Figure 2.. Incident cases of chronic obstructive pulmonary disease (COPD) and agreement among three spirometric diagnostic criteria: FEV1/FVC < 0.7 post-bronchodilator; FEV1/FVC < LLN post-bronchodilator; and FEV1/FEV6 < LLN post-bronchodilator.
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