Background
Methods
Document search
Document triage and selection
Analysis of the collected information
Results
Information included in the review
Prevalence
Criteria used to define COPD | Country (sample size) | Study population | Ageb(yr) | Prevalence (%) |
---|---|---|---|---|
Symptomsc
| ||||
Cerveri et al., 2003 [15] | Italy (18,645) | General population | 20-44 | 9.5 |
Huchon et al., 2002 [16] | France (14,076) | General population | ≥25 | 4.1 |
Cerveri et al., 2001 [17] | 16 countries (14,819) | General population | 20-44 | 2.6 |
Physician reports | ||||
Cazzola et al., 2009 [18] | Italy (15,229) | General population | NS | 2.5 |
Schirnhofer et al., 2007 [19] | Austria (1,258) | General population | ≥40 | 5.6 |
Montnemery et al., 2006 [20] | Sweden (3,692) | General population | 20-59 | 3.6 |
Hedman et al., 1999 [21] | Finland (3,102) | General population | 18-65 | 3.7 |
Montnemery et al., 1998 [22] | Sweden (8,469) | General population | 20-59 | 4.6 |
Lundback et al., 1991 [23] | Sweden (6,610) | General population | 35-66 | 4.1 |
Functional respiratory tests | ||||
Miravitlles et al., 2009 [24] | Spain (4,274) | General population | 56.6 (10.7) | 10.2 |
Van Durme et al., 2009 [25] | Netherlands (7,983) | General population | ≥55 | 11.6 |
Hansen et al., 2008 [26] | Denmark (4,757) | General population | 45-84 | 12.0 |
Bednarek et al., 2008 [27] | Poland (1,960) | Primary care | 56.7 (11.6) | 9.3 |
Roche et al., 2008 [28] | France (4,764) | Health prevention center | 59.9 (10.1) | 2.6 |
Buist et al., 2007 [8] | Austria (1,258) | General population | ≥40 | 26.1d
|
Germany (683) | 13.3 | |||
Poland (526) | 22.1 | |||
Norway (638) | 18.8 | |||
Shahab et al., 2006 [29] | United Kingdom (8,215) | General population | 55.5 (13.5) | 13.3 |
Stavem et al., 2006 [30] | Norway (1,619) | Occupational cohort | 49.8 (5.5) | 16.4 |
Sichletidis et al., 2005 [31] | Greece (6,112) | General population | 21-80 | 5.6 |
Murtagh et al., 2005 [32] | Ireland (2,484) | General population | 53.3 (8.6) | 6.3 |
Tzanakis et al., 2004 [33] | Greece (888) | General population | ≥35 | 8.4 |
Hasselgren et al., 2001 [34] | Sweden (4,814) | General population | 43 (14.8) | 2.1 |
Peña et al., 2000 [35] | Spain (3,978) | General population | 40-69 | 9.1 |
Viegi et al., 2000 [36] | Italy (1,727) | General population | ≥25 | 11.0 or 18.3 |
Jaen et al., 1999 [11] | Spain (497) | General population | 20-70 | 7.2 |
Dickinson et al., 1999 [37] | United Kingdom (353) | General population | 68.25 | 9.9 |
Marco Jordán et al., 1998 [12] | Spain (460) | General population | 40-60 | 6.8 |
Renwick & Connolly, 1996 [38] | United Kingdom (783) | General practitioner | 66.1 | 9.0 |
Brotons et al., 1994 [13] | Spain (642) | General population | 35-65 | 6.4 |
Bakke et al., 1991 [39] | Norway (1,275) | General population | 42 (16.1) | 4.5 |
Models | ||||
Peabody et al., 2005 [40] | Spain | Total population | ≥30 | 6.2 |
Norway | 6.3 | |||
Poland | 6.7 | |||
Feenstra et al., 2001 [41] | Netherlands | Total population | ≥20 | 1.5 |
Stang et al., 2000 [42] | Spain | Total population | ≥45 | 10.3 |
Italy | 11.1 | |||
France | 10.4 | |||
United Kingdom | 15.0 |
Severity
Severityc(%) | |||||||
---|---|---|---|---|---|---|---|
Study population | Country (sample size) | Criteria | Ageb(yr) | Stage 1 | Stage 2 | Stage 3 | Stage 4 |
General population | |||||||
Buist et al., 2007 [8] | Austria (1,349) | GOLD 2006 | ≥40 | 59.4 | 35.2 | 5.4 | |
Germany (713) | 55.3 | 38.6 | 6.1 | ||||
Poland (603) | 50.7 | 40.7 | 8.6 | ||||
Norway (707) | 55.8 | 37.8 | 6.4 | ||||
Shahab et al., 2006 [29] | United Kingdom (8,215) | GOLD 2006 | 55.5 (13.5) | 41.6 | 43.9 | 14.5 | |
Lindberg et al., 2006 [47] | Sweden (1,237) | GOLD 2006 | 46-77 | 57.0 | 37.0 | 5.0 | 1.0 |
BTS 1997 | 65.0 | 27.0 | 8.0 | NA | |||
De Marco et al., 2004 [48]d
| Belgium (1,122) | GOLD 2003 | 20-44 | 58.6 | 41.4 | ND | |
Denmark (394) | 56.4 | 43.6 | ND | ||||
France (2,137) | 66.7 | 33.3 | ND | ||||
Germany (1,983) | 64.8 | 35.2 | ND | ||||
Italy (910) | 69.4 | 30.6 | ND | ||||
Ireland (454) | 75.3 | 24.7 | ND | ||||
Netherlands (1,362) | 74.3 | 25.7 | ND | ||||
Norway (969) | 40.7 | 59.3 | ND | ||||
Spain (1,942) | 59.2 | 40.8 | ND | ||||
Sweden (1,859) | 79.3 | 20.7 | ND | ||||
Switzerland (853) | 76.3 | 23.7 | ND | ||||
United Kingdom (1,198) | 69.8 | 30.2 | ND | ||||
Tzanakis et al., 2004 [33] | Greece (888) | ERS 1995 | ≥35 | 58.2 | 25.6 | 16.2 | NA |
Jansson et al., 2002 [49] | Sweden (212) | BTSe
| 28-29 | 75.0 | 25.0 | 0 | 0 |
43-44 | 46.6 | 46.6 | 6.8 | 0 | |||
49-50 | 16.0 | 64.0 | 12.0 | 8.0 | |||
58-59 | 15.4 | 57.7 | 15.4 | 11.5 | |||
64-65 | 6.9 | 29.3 | 41.4 | 22.4 | |||
73-74 | 14.3 | 21.4 | 47.6 | 16.7 | |||
79-80 | 9.8 | 34.2 | 48.8 | 7.3 | |||
Viegi et al., 2000 [36] | Italy (1,727) | ERS 1995 | ≥25 | 81.0 | 14.0 | 5.0 | NA |
ATS 1995 | 98.2 | 1.8 | 0 | NA | |||
Clinicalf
| 86.1 | 13.9 | |||||
Von Hertzen et al., 2000 [50]g
| Finland (7,217) | ≥30 | 59.8 | 34.1 | 6.1 | NA | |
General practitioner and/or chest specialist | |||||||
Izquierdo et al., 2009 [51] | Spain (3,619) | GOLD 2006 | 67.0 (10.8) | 20.1 | 54.0 | 22.1 | 3.8 |
Bednarek et al., 2008 [27] | Poland (1,960) | GOLD 2006 | 56.7 (11.6) | 30.6 | 51.4 | 15.3 | 2.7 |
Hoogendoorn et al., 2006 [52] | Sweden (481) | GOLD 2006 | 65.5 | 30.0 | 51.0 | 17.0 | 2.0 |
Piperno et al., 2005 [14] | France (3,411) | SPLF 1996 | 58.4 (9.9) | 31.3 | 50.2 | 18.5 | NA |
Detournay et al., 2004 [53] | France (255) | SPLF 1996 | 67.1 | 56.0 | 27.0 | 17.0 | NA |
Soriano et al., 2000 [54] | United Kingdom (23,277) | Prescriptions | 66.7 (15.5) | 35.5 | 56.4 | 8.1 | NA |
Hospital | |||||||
Soler-Cataluña et al., 2005 [55] | Netherlands (304) | GOLD 2006 | 71 (9) | 6.6 | 35.8 | 33.6 | 24.0 |
Tsoumakidou et al., 2004 [56] | Greece (67) | ERS 1995 | 69.0 | 0 | 4.5 | 95.5 | NA |
BTS 1997 | 69.5 | 1.5 | 14.9 | 83.6 | NA | ||
ATS 1995 | 67.6 | 4.5 | 28.3 | 67.2 | NA | ||
GOLD 2001 | 69.5 | 0 | 58.2 | 41.8 | |||
Kornmann et al., 2003 [57] | Germany (1,434) | GOLD 2001 | {55} | 7.9 | 73.0 | 19.1 |
Exacerbations
Diagnostic method | Description of symptoms |
---|---|
Treatment | |
Burge et al., 2003 [58]b
| Chest problem requiring treatment with oral corticosteroids and/or antibiotics as defined by the treating physician |
Calverley et al., 2003 [59] | Worsening of COPD symptoms that required treatment with antibiotics, oral corticosteroids or both |
Jones et al., 2003 [60]b
| Chest problems requiring treatment with antibiotics and/or oral corticosteroids |
Andersson et al., 2002 [61] | Increased dose of current treatment and/or treatment with antibiotics or systemic corticosteroids and/or general practitioner or outpatient visit or hospital admission |
Burge et al., 2000 [62]b
| Worsening of respiratory symptoms that required treatment with oral corticosteroids, antibiotics or both as judged by the general practitioner |
Symptoms | |
Effing et al., 2009 [63] | Presence for at least 2 consecutive days of an increase in any two major symptoms or an increase in one major and one minor symptom |
Worth et al., 2009 [64] | A complex of at least two respiratory adverse events with a duration of more than 3 days |
Schermer et al., 2009 [65] | Episode with one or more subsequent unscheduled contacts with either a general practitioner or a chest physician because of worsening of respiratory symptoms |
O'Reilly et al., 2006 [66]c
| Symptom-based: Symptom score of at least 2 for 2 consecutive days with no score for at least two of these symptoms in the previous 5 days Healthcare-based: Need to take antibiotics and/or oral corticosteroids for chest problem |
Wilkinson et al., 2006 [67] | Not defined but specified as symptom-based |
Donaldson et al., 2003 [68] | An increase in either two or more major symptoms or any one major symptom plus any minor symptoms occurring on 2 or more consecutive days |
Seemungal et al., 2000 [69] | Presence for at least 2 consecutive days of an increase in any two major symptoms or an increase in one major and one minor symptom |
Treatment and symptoms | |
Seemungal et al., 2008 [70] | Sustained worsening of baseline respiratory symptoms for at least 2 days that required treatment with oral corticosteroids and/or antibiotics |
Tashkin et al., 2008 [71] | Increase or new onset of more than one respiratory symptom (cough, sputum, sputum purulence, wheezing or dyspnea) lasting 3 days or more and requiring treatment with an antibiotic or a systemic corticosteroid |
Calverley et al., 2008 [72] | Clinically significant worsening of COPD symptoms requiring treatment with antibiotics and/or systemic steroids |
Wedzicha et al., 2008 [73] | Symptom worsening that required treatment with oral corticosteroids and/or antibiotics or required hospitalization |
Dusser et al., 2006 [74] | Onset of at least one clinical descriptor (worsening of dyspnea, cough or sputum production, appearance of purulent sputum, fever (>38°C), appearance of a new chest radiograph abnormality) lasting ≥2 days and requiring a new prescription or an increase in the dose of β2-agonists, antibiotics, corticosteroids or bronchodilators |
Soler-Cataluña et al., 2005 [55] | Sustained increase in respiratory symptomatology compared with baseline requiring modification of regular medication and hospital treatment (acute exacerbation of COPD) |
Oostenbrink et al., 2004 [75] | Complex of respiratory symptoms (new onset or worsening of more than one symptom such as cough, sputum, dyspnea or wheeze) lasting for ≥3 days |
Brusasco et al., 2003 [76] | Complex of respiratory symptoms (new onset or an increase in at least one of the following: cough, sputum, dyspnea, wheeze, chest discomfort) lasting at least 3 days and usually associated with therapeutic intervention |
Model | |
Borg et al., 2004 [77] | Increase in any two major symptoms (dyspnea, sputum purulence, sputum amount) or an increase in one major and one minor symptom (wheeze, sore throat, cough, and symptoms of a common cold, which were nasal congestion and/or discharge) for at least 2 consecutive days |
Not defined | |
Detournay et al., 2004 [53] | ND |
Exacerbation definition group (study typeb) | Country (sample size) | Classification (stage of COPD) | Mean number of exacerbations per patient and per yearc
| Treatment |
---|---|---|---|---|
Treatment | ||||
Burge et al., 2003 [58]d (CT) | United Kingdom (524) | GOLD (2 or 3) | 1.6-1.7 | Placebo |
1.1-1.4 | Fluticasone propionate | |||
Calverley et al., 2003 [59] (CT) | 25 countries (1,974) | GOLD (2 or 3) | 1.3 | Placebo |
1.0 | Salmeterol | |||
1.0 | Fluticasone | |||
1.0 | Salmeterol and fluticasone | |||
Jones et al., 2003 [60]d (CT) | United Kingdom (751) | GOLD (1 or 2) | 1.0 | Placebo |
0.7 | Fluticasone | |||
GOLD (3 or 4) | 1.7 | Placebo | ||
1.5 | Fluticasone | |||
Andersson et al., 2002 [61] (CT) | Sweden (191) | GOLD/BTS | 1.2 | |
Burge et al., 2000 [62]d (CT) | United Kingdom (751) | GOLD (2 or 3) | 1.9 (2.6) | Placebo |
1.4 (1.9) | Fluticasone | |||
Symptoms | ||||
Effing et al., 2009 [63] (CT) | Netherlands (142) | GOLD (2 or 3) | 3.5 (2.7) | |
Worth et al., 2009 [64]e (CT) | Germany (220) | GOLD (3 or 4) | 0.9 | Placebo |
0.4 | Cineole | |||
Schermer et al., 2009 [65] (CT) | Netherlands (286) | GOLD (1-3) | 0.7 | Placebo |
0.9 | Fluticasone | |||
1.0 |
N-acetylcysteine | |||
O'Reilly et al., 2006 [66] (OS) | United Kingdom (309) | GOLD (1 or 2) | 2.2 [1.9-2.7] | Symptom-defined |
2.3 [2.0-2.8] | Healthcare-defined | |||
GOLD (3 or 4) | 2.5 [2.1-2.9] | Symptom-defined | ||
3.2 [2.8-3.7] | Healthcare-defined | |||
Wilkinson et al., 2006 [67] (OS) | United Kingdom (74) | GOLD (2 or 3) | 2.5 {1.3-3.8} | |
Donaldson et al., 2003 [68] (OS) | United Kingdom (132) | GOLD (2 or 4) | 2.5 {1.3-3.9} | |
Seemungal et al., 2000 [69] (OS) | United Kingdom (101) | GOLD (2 or 4) | 2.4 {1.3-3.8} | |
Treatment and symptoms | ||||
Seemungal et al., 2008 [70] (CT) | United Kingdom (109) | GOLD (2 or 3) | 2.0 | Placebo |
1.0 | Erythromycin | |||
Tashkin et al., 2008 [71] (CT) | 37 countries (5,993) | GOLD (2-4) | 0.8 | Placebo |
0.7 | Tiotropium | |||
Calverley et al., 2008 [72] (CT) | 11 countries (911) | GOLD (2 or 3) | 1.0 | Placebo |
0.6 | Mometasone furoate | |||
Wedzicha et al., 2008 [73] (CT) | 20 countries (1,323) | GOLD (3 or 4) | 1.3 | SFC |
1.3 | Tiotropium | |||
Dusser et al., 2006 [74] (CT) | France (1,010) | GOLD (1 or 2) | 2.0 | Placebo |
1.2 | Tiotropium | |||
GOLD (3 or 4) | 1.8 | Placebo | ||
2.7 | Tiotropium | |||
Soler-Cataluña et al., 2005 [55] (OS) | Spain (304) | GOLD (1) | (75, 25, 00)f
| |
GOLD (2) | (60, 35, 05)f
| |||
GOLD (3) | (56, 32, 12)f
| |||
GOLD (4) | (34, 40, 26)f
| |||
Oostenbrink et al., 2004 [75] (CT) | Netherlands and Belgium (519) | GOLD (1-4) | 1.0 (0.1) | Placebo |
0.7 (0.1) | Fluticasone | |||
Brusasco et al., 2003 [76] (CT) | 18 countries (1,207) | GOLD (2 or 3) | 1.5 | Placebo |
1.2 | Salmeterol | |||
1.1 | Tiotropium | |||
Model | ||||
Borg et al., 2004 [77] (M) | Netherlands | GOLD (1) | (0.05, 0.07, 0.01)g
| |
GOLD (2) | (1.01, 1.31, 0.14)g
| |||
GOLD (3) | (1.06, 1.45, 0.17)g
| |||
GOLD (4) | (1.47, 1.72, 0.33)g
| |||
Not defined | ||||
Detournay et al., 2004 [53] (OS) | France (255) | Moderate | 1.7 | |
Moderate to | 1.5 | |||
severe | ||||
Severe | 2.0 |
Mortality
Annual mortality rate (per 100,000 inhabitants) | |||||||
---|---|---|---|---|---|---|---|
Population | Country | Year(s) | Age (yr) | Global | Male | Female | Classification codes used |
General population | |||||||
Eurostatb,c [10] | Austria | 2007 | 19.4 | 30.8 | 12.1 | ICD 10 (J40-J44, J47) | |
Bulgaria | 15.8 | 26.7 | 07.9 | ||||
Cyprus | 09.3 | 15.5 | 04.7 | ||||
Czech Republic | 14.7 | 24.1 | 08.5 | ||||
Estonia | 10.7 | 24.2 | 04.4 | ||||
Finland | 12.9 | 25.3 | 05.4 | ||||
France | 07.2 | 12.5 | 03.8 | ||||
Germany | 16.3 | 24.9 | 10.8 | ||||
Greeced
| 10.9 | 14.8 | 07.9 | ||||
Hungary | 36.1 | 56.5 | 23.6 | ||||
Lithuania | 22.4 | 49.0 | 08.5 | ||||
Latvia | 09.7 | 22.4 | 03.0 | ||||
Malta | 16.0 | 35.4 | 02.7 | ||||
Netherlands | 26.0 | 39.6 | 18.7 | ||||
Poland | 16.8 | 32.0 | 07.8 | ||||
Romania | 20.6 | 33.8 | 11.4 | ||||
Spain | 18.4 | 37.1 | 06.1 | ||||
Sweden | 15.1 | 17.6 | 13.6 | ||||
Slovakia | 12.8 | 24.5 | 05.9 | ||||
Slovenia | 13.2 | 23.4 | 07.5 | ||||
United Kingdom | 28.4 | 35.5 | 23.7 | ||||
Hurd et al., 2000 [78] | Austria | 1997 | 35-74 | 32 | 6 | ICD 9 (490-496) | |
Bulgaria | 1994 | 38 | 8 | ||||
France | 1995 | 26 | 5 | ||||
Germany | 1997 | 28 | 11 | ||||
Greece | 1996 | 12 | 1 | ||||
Hungary | 1995 | 75 | 23 | ||||
Italy | 1993 | 30 | 4 | ||||
Netherlands | 1995 | 43 | 15 | ||||
Poland | 1996 | 43 | 8 | ||||
Portugal | 1996 | 38 | 7 | ||||
Romania | 1996 | 61 | 18 | ||||
Spain | 1995 | 45 | 6 | ||||
Sweden | 1996 | 22 | 12 | ||||
United Kingdom | 1997 | 48 | 31 | ||||
Siafakas et al., 1995 [45] | Austria | 1988-1991 | NS | 18 | 6 | ICD 9 (490-493) | |
Belgium | 28 | 9 | |||||
Bulgaria | 11 | 6 | |||||
Denmark | 34 | 20 | |||||
Finland | 22 | 4 | |||||
France | 10 | 3 | |||||
Greece | 03 | 2 | |||||
Hungary | 40 | 16 | |||||
Italy | 25 | 8 | |||||
Netherlands | 20 | 5 | |||||
Poland | 29 | 8 | |||||
Portugal | 14 | 5 | |||||
Romania | 20 | 12 | |||||
Spain | 10 | 3 | |||||
Sweden | 11 | 5 | |||||
United Kingdom | 12 | 6 | |||||
Hospital populatione
| |||||||
Gudmundsson et al., 2006f [81] | SweNorFing
| 2002 | 72.1 ± 8.7 | 293 | ICD 10 (J40-J47) | ||
Groeneweger et al., 2003h [79] | Netherlands | 2001 | 70.6 ± 8.5 | 230 | COPD-ATS | ||
Almagro et al., 2002i [80] | Spain | 1999 | 72.0 ± 9 | 220 | COPDj
|