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COPD severity in some provinces of the Department of Boyacá (Colombia) according to the ALAT 2019 and GOLD 2022 guidelines
Severidad de la EPOC en algunas provincias del departamento de Boyacá (Colombia) según las guías ALAT 2019 y GOLD 2022
DOI:
https://doi.org/10.15446/revfacmed.v72n3.111494Palabras clave:
Pulmonary Disease, Chronic Obstructive, Airway Obstruction, Signs and Symptoms, Respiratory, Symptom Exacerbation, Respiratory function tests, Quality of Life (en)Enfermedad pulmonar obstructiva crónica, Obstrucción de las vías aéreas, Signos y síntomas respiratorios, Exacerbación de los síntomas, Pruebas de función respiratoria, Calidad de vida (es)
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Introduction: Chronic obstructive pulmonary disease (COPD) is a condition that progressively limits the ability to perform exercise and activities of daily living, negatively impacting quality of life.
Objective: To determine the severity of COPD according to the criteria of the Latin American COPD Clinical Practice Guidelines (ALAT 2019) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD 2022) pocket guide for the diagnosis, treatment, and prevention of COPD in patients suffering from this condition in Boyacá, Colombia.
Materials and methods: A retrospective, descriptive, cross-sectional, correlational study was carried out in 248 COPD patients from municipalities in the Central and Sugamuxi provinces of the department of Boyacá (Colombia). Sociodemographic and clinical data were collected, spirometry was performed, and the modified Medical Research Council (mMRC) dyspnea scale and the COPD assessment questionnaire (CAT) were administered. The Kruskal-Wallis test was used to evaluate the association of the clinical and sociodemographic variables considered with the classification of COPD severity according to the criteria of the ALAT 2019 and GOLD 2022 guidelines.
Results: According to the ALAT guideline criteria, COPD was mild in 109 (43.95%) patients, moderate in 104 (41.93%), and severe in 35 (14.11%). Meanwhile, according to the GOLD guidelines, 108 (43.55%) had GOLD-1 COPD, 106 (42.74%) had GOLD-2 COPD, and 34 (13.71%) had GOLD-3 COPD; no cases of GOLD-4 COPD were reported. In addition, 99.06% of patients with mild COPD were classified as COPD GOLD-1 (81.65% in the GOLD-1A group), 98.06% of cases with moderate COPD were classified as COPD GOLD-2 (54.80% in the GOLD-2B group), and 91.42% of subjects with severe COPD were classified as COPD GOLD-3 (62.85% in the GOLD3D group).
Conclusions: COPD severity can be classified using both the ALAT and GOLD guidelines, since the distribution of COPD types depending on severity was similar in both guidelines (mild, moderate, severe vs. GOLD-1, GOLD-2, GOLD-3), with mild COPD-GOLD-1 being the most frequent classification in our sample, followed by moderate COPD-GOLD-2.
Introducción. La enfermedad pulmonar obstructiva crónica (EPOC) es una condición que limita progresivamente la capacidad para realizar ejercicio y actividades de la vida diaria, impactando negativamente la calidad de vida.
Objetivo. Determinar la severidad de la EPOC según los criterios de la Guía de Práctica Clínica Latinoamericana de EPOC (ALAT 2019) y la guía de bolsillo para el diagnóstico, manejo y prevención de la EPOC de la Global Initiative for Chronic Obstructive Lung Disease (GOLD 2022) en pacientes con EPOC en Boyacá, Colombia.
Materiales y métodos. Estudio transversal descriptivo correlacional realizado en 248 pacientes con EPOC de municipios de las provincias Centro y Sugamuxi del departamento de Boyacá. Se recolectaron datos sociodemográficos y clínicos, se realizó espirometría y se aplicaron la escala modificada de disnea del Medical Research Council (mMRC) y el cuestionario de evaluación de la EPOC (CAT). Se usó la prueba de Kruskal-Wallis para evaluar la asociación de las variables clínicas y sociodemográficas consideradas con la clasificación de la severidad de la EPOC según los criterios de las guías ALAT 2019 y GOLD 2022.
Resultados. Según los criterios de la guía ALAT, 109 (43.95%) pacientes tenían EPOC leve; 104 (41.93%), EPOC moderada, y 35 (14.11%), EPOC grave, mientras que, de acuerdo con la guía GOLD, 108 (43.55%) tenían EPOC GOLD-1; 106 (42.74%), EPOC GOLD-2, y 34 (13.71%), EPOC GOLD-3; no hubo casos de EPOC GOLD-4. Además, 99.06% de los pacientes con EPOC leve fueron clasificados como EPOC GOLD-1 (81.65% en el grupo GOLD-1A); 98.06% de aquellos con EPOC moderado, como EPOC GOLD-2 (54.80% en el grupo GOLD-2B), y 91.42% de aquellos con EPOC grave, como EPOC GOLD-3 (62.85% en el grupo GOLD3D).
Conclusiones. La clasificación de la severidad de la EPOC puede realizarse tanto con la guía ALAT, como con la guía GOLD, dado que la distribución de los tipos de EPOC según su severidad fue similar en ambas guías (leve, moderada, grave vs. GOLD-1, GOLD-2, GOLD-3), siendo la EPOC leve-GOLD-1 la clasificación más frecuente en nuestra muestra, seguida de la EPOC moderada-GOLD-2.
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