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      The Geographical Distribution of Morbidity Caused By Chronic Obstructive Pulmonary Disease in Turkey: COPDTURKEY-2

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          Abstract

          Background:

          Chronic obstructive pulmonary disease (COPD) is one of the most prevalent causes for morbidity and mortality, and it creates a cumulative economic and social burden.

          Aims:

          To determine the distribution of the prevalence of patients in Turkey who were diagnosed with COPD and their morbidity rates, according to the regions and cities they belong to. Moreover, the study contributes to the prevention and cure services of COPD that should be planned in the future.

          Study Design:

          A retrospective cohort.

          Methods:

          The database of the Social Security Institution from 2016 has been scanned. All the data with prescription registration, with the code ICD-10, J44.0-J44.9, which were aimed for diagnosing and/or cure, have been evaluated with a retrospective cohort.

          Results:

          In 2016, 955,369 patients who were admitted as outpatients to the hospitals were diagnosed with COPD. The average number of annual COPD cases that were admitted was 2.09. Twenty percent (20%) of the outpatient applications were via emergency room. The rate of hospitalization among the applicants was 17.75%, with a total of 1,994,325. The average annual number of hospitalizations of men was higher than that of women. The average number of hospitalization days was 6.52. The region with the highest prevalence of outpatient admission and hospitalization was the Black Sea Region.

          Conclusion:

          The high rate of hospitalization was considered to be the outcome of the insufficient “outpatient” management.

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          Most cited references29

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          COPD in Never Smokers

          Background: Never smokers comprise a substantial proportion of patients with COPD. Their characteristics and possible risk factors in this population are not yet well defined. Methods: We analyzed data from 14 countries that participated in the international, population-based Burden of Obstructive Lung Disease (BOLD) study. Participants were aged ≥ 40 years and completed postbronchodilator spirometry testing plus questionnaires about respiratory symptoms, health status, and exposure to COPD risk factors. A diagnosis of COPD was based on the postbronchodilator FEV1/FVC ratio, according to current GOLD (Global Initiative for Obstructive Lung Disease) guidelines. In addition to this, the lower limit of normal (LLN) was evaluated as an alternative threshold for the FEV1/FVC ratio. Results: Among 4,291 never smokers, 6.6% met criteria for mild (GOLD stage I) COPD, and 5.6% met criteria for moderate to very severe (GOLD stage II+) COPD. Although never smokers were less likely to have COPD and had less severe COPD than ever smokers, never smokers nonetheless comprised 23.3% (240/1,031) of those classified with GOLD stage II+ COPD. This proportion was similar, 20.5% (171/832), even when the LLN was used as a threshold for the FEV1/FVC ratio. Predictors of COPD in never smokers include age, education, occupational exposure, childhood respiratory diseases, and BMI alterations. Conclusion: This multicenter international study confirms previous evidence that never smokers comprise a substantial proportion of individuals with COPD. Our data suggest that, in addition to increased age, a prior diagnosis of asthma and, among women, lower education levels are associated with an increased risk for COPD among never smokers.
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            Epidemiology and costs of chronic obstructive pulmonary disease.

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              Impact of COPD in North America and Europe in 2000: subjects' perspective of Confronting COPD International Survey.

              To date, no international surveys estimating the burden of chronic obstructive pulmonary disease (COPD) in the general population have been published. The Confronting COPD International Survey aimed to quantify morbidity and burden in COPD subjects in 2000. From a total of 201,921 households screened by random-digit dialling in the USA, Canada, France, Italy, Germany, The Netherlands, Spain and the UK, 3,265 subjects with a diagnosis of COPD, chronic bronchitis or emphysema, or with symptoms of chronic bronchitis, were identified. The mean age of the subjects was 63.3 yrs and 44.2% were female. Subjects with COPD in North America and Europe appear to underestimate their morbidity, as shown by the high proportion of subjects with limitations to their basic daily life activities, frequent work loss (45.3% of COPD subjects of <65 yrs reported work loss in the past year) and frequent use of health services (13.8% of subjects required emergency care in the last year), and may be undertreated. There was a significant disparity between subjects' perception of disease severity and the degree of severity indicated by an objective breathlessness scale. Of those with the most severe breathlessness (too breathless to leave the house), 35.8% described their condition as mild or moderate, as did 60.3% of those with the next most severe degree of breathlessness (breathless after walking a few minutes on level ground). This international survey confirmed the great burden to society and high individual morbidity associated with chronic obstructive pulmonary disease in subjects in North America and Europe.
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                Author and article information

                Journal
                Balkan Med J
                Balkan Med J
                BMJ
                Balkan Medical Journal
                Galenos Publishing
                2146-3123
                2146-3131
                May 2020
                10 April 2020
                : 37
                : 3
                : 157-162
                Affiliations
                [1 ]Clinic of Chest Diseases, Sincan Dr. Nafiz Körfez State Hospital, Ankara, Turkey
                [2 ]Clinic of Chest Diseases, University of Health Sciences, Dr. Abdurrahman Yurtaslan Ankara Oncology Research and Training Hospital, Ankara, Turkey
                [3 ]Department of Chest Diseases, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
                [4 ]Department of Chest Diseases, Gazi University School of Medicine, Ankara, Turkey
                [5 ]Deputy President, Social Security Institution, Ankara, Turkey
                Author notes
                * Address for Correspondence: Clinic of Chest Diseases, Sincan Dr. Nafiz Körfez State Hospital, Ankara, Turkey E-mail: mhturkkani@ 123456gmail.com
                Author information
                https://orcid.org/0000-0003-1503-7343
                https://orcid.org/0000-0002-9344-7586
                https://orcid.org/0000-0003-0568-3309
                https://orcid.org/0000-0001-6160-3778
                https://orcid.org/0000-0001-5335-0571
                https://orcid.org/0000-0002-8051-433X
                https://orcid.org/0000-0002-6875-5018
                https://orcid.org/0000-0002-9204-3838
                Article
                37274
                10.4274/balkanmedj.galenos.2020.2019.10.79
                7161616
                32054261
                ebe172cf-8b62-4422-93b4-ec4ef850eb29
                ©Copyright 2020 by Trakya University Faculty of Medicine

                The Balkan Medical Journal published by Galenos Publishing House.

                History
                : 19 October 2019
                : 12 February 2020
                Categories
                Original Article

                chronic obstructive pulmonary disease,prevalence,morbidity,turkey

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