TY - JOUR T1 - COPD detected with screening: Impact on patient management and prognosis JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - 4417 AU - Loes C.M. Bertens AU - Johannes B. Reitsma AU - Yvonne van Mourik AU - Jan-Willem J. Lammers AU - Karel G.M. Moons AU - Arno W. Hoes AU - Frans H. Rutten Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/4417.abstract N2 - Background: Uncertainty exists whether screening older adults for COPD is worthwhile.Aim: To assess the clinical consequences of screening for COPD in frail elderly with dyspnoea, in terms of the use of pulmonary drugs, smoking cessation, hospitalizations, and all-cause mortality.Methods: Community-dwelling frail elderly, aged 65 years and older with dyspnoea (≥2 on the MRC dyspnoea scale) or exercise intolerance participated in the screening study. The final diagnosis was assigned by an expert panel based on all data from history taking, physical examination, and pre- and post-dilatory results from spirometry. Follow-up data was collected from the electronic medical files of the patients' general practitioners.Results: Of the 386 patients screened, 84 (21.8%) new cases of COPD were detected, and another 50 (13.0%) patients had a re-confirmation of their COPD diagnosis. In 16 (4.1%) persons previously known with a diagnosis of COPD the diagnosis could not be confirmed. Pulmonary drug use changed in 13.7% of all screened patients, and in 17.9% (15/84) in those with newly detected COPD in the first 6 months. After one year of follow up, 25.9% in all patients and 32.1% of the patients with screen-detected COPD were hospitalised. The 1-year mortality rate was low in all patients (3.6%), including those with screen-detected COPD (2.4%). Six of the 34 (16.2%) smokers among the participants quit smoking within 6 months, but none of the smokers with newly detected COPD quit smoking.Conclusions: Although, many new cases of COPD can be detected with screening of frail elderly with dyspnoea, the short-term impact on patient management and prognosis is small. ER -