The importance of dyspnoea in the diagnosis of chronic obstructive pulmonary disease - a descriptive analysis of a stable cohort in Portugal (SAFE Trial) [A importância da dispneia no diagnóstico da doença pulmonar obstrutiva crónica - uma análise descritiva de uma coorte estável em Portugal (ensaio clínico SAFE)]

Introduction: the aim of this study was to determine patient-perceived characteristics of chronic obstructive pulmonary disease (copd) in patients participating in a large trial evaluating tiotropium bromide. patients and methods: baseline symptoms were assessed by means of a standardized questionnaire. patients reported symptoms that led to diagnosis as well as their current most troublesome symptom. results: data were obtained from 298 patients,mostly male (95 %),with mean (standard deviation) baseline forced expiratory volume in 1 second of 1.1 (0.4) l (40.6 [13.3] % of predicted),mean disease duration of 14.4 (10.1) years and smoking history of 55.1 (25.3) pack-years. dyspnoea was the most frequently reported symptom leading to copd diagnosis (55.0 % of patients),followed by cough (33.2 %). dyspnoea was also the current most troublesome symptom (82.6 %),followed by cough (8.4 %). the presence of dyspnoea or cough was independent of copd severity. the most commonly reported co-morbidities were cardiovascular disorders (49 % of patients),gastrointestinal disorders (20 %) and metabolic disorders (16 %),mainly diabetes mellitus. conclusions: this analysis confirms the importance of dyspnoea as the most common symptom leading to initial copd diagnosis and the symptom most troublesome to patients. co-morbidities are common among copd patients,and hence spirometric testing is appropriate in a patient who presents with dyspnoea associated with such a condition. © 2010 published by elsevier españa,s.l. on behalf of sociedade portuguesa de pneumologia. all rights reserved.