¿Mienten los pacientes con EPOC sobre su hábito tabáquico? / Do COPD patients lie about their smoking habit?

OBJETIVO: Determinar la tasa de decepción o concordancia entre la respuesta de los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) sobre su hábito tabáquico y la medición del mismo por cooximetría en una consulta monográfica EPOC. DISEÑO: Estudio observacional prospectivo para determinar la concordancia entre los valores de cooximetría y la respuesta a entrevista clínica sobre hábito tabáquico. EMPLAZAMIENTO: Consulta monográfica de EPOC, Neumología, Sevilla. PARTICIPANTES: Pacientes con diagnóstico confirmado de EPOC en cualquier grado. INTERVENCIONES: Entrevista clínica y medición de monóxido de carbono mediante cooximetría. MEDICIONES PRINCIPALES: Valores de cooximetría, respuestas sobre hábito tabáquico, variables sociodemográficas. RESULTADOS: Se incluyó un total de 169 pacientes (n: 169) de los cuales, 107 presentaron valores menores o iguales 6 ppm frente a 62 con valores mayores a 6 ppm, determinando una prevalencia de tabaquismo activo del 36,7%. La tasa de decepción fue del 19,5% del total de la muestra (24,3% de entre todos los que afirmaban no fumar), con una kappa de Cohen de 0,48 y p < 0,000. El 40% de los pacientes confesó no haber dicho la verdad. No se encontró ninguna relación de este dato con la edad, el consumo acumulado de tabaco ni el FEV1. Se halló una relación significativa con el sexo (tasa de decepción: 31,8% en las mujeres vs. 15,2% en los hombres, p 0,017). CONCLUSIONES: A pesar de nuestros intentos para que los pacientes dejen de fumar, la tasa de decepción en nuestra consulta fue considerable, mayor entre las mujeres, exfumadores recientes o en proceso de abandono, por lo que sería fundamental incorporar medidas objetivas como el cooxímetro en el abordaje de este tipo de pacientes

OBJECTIVE: To determine the deception rate or concordance between the interview on smoking and cooximetry in COPD patients from a monographic consultation. DESIGN: Prospective observational study to evaluate the concordance between the values of cooximetry and the response to a clinical interview on smoking. SETTING: COPD monographic consultation, Pneumology, Seville. PARTICIPANTS: Patients with a confirmed diagnosis of COPD in any degree. INTERVENTIONS: Clinical interview and measurement of carbon monoxide by cooximetry. MAIN MEASUREMENTS: Cooximetry values, responses on smoking, sociodemographic variables. RESULTS: n: 169. 107 patients presented values less than or equal to 6 ppm compared to 62 with values greater than 6 ppm, determining a prevalence of active smoking of 36.7%. The deception rate was 19.5% of the total sample (24.3% of all those who claimed not to smoke), with a Cohen kappa of 0.48 and p < 0.000. 40% of patients confessed not having told the truth. No relationship of this data was found with age, accumulated tobacco consumption or FEV1. A significant relationship with sex was found (deception rate: 31.8% in women vs. 15.2% in men, p 0.017). CONCLUSIONS: In spite of our attempts to make patients stop smoking, a considerable deception rate was found in our consultation; higher among women, recent ex-smokers or in the process of abandonment, so it would be essential to incorporate objective measures such as the cooximeter in the approach of this type of patient

Fístula traqueoesofágica secundaria a ventilación mecánica prolongada / Tracheoesophageal Fistula due to Prolonged Mechanical Ventilation

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[Do COPD patients lie about their smoking habit?] / ¿Mienten los pacientes con EPOC sobre su hábito tabáquico?

OBJECTIVE: To determine the deception rate or concordance between the interview on smoking and cooximetry in COPD patients from a monographic consultation. DESIGN: Prospective observational study to evaluate the concordance between the values of cooximetry and the response to a clinical interview on smoking. SETTING: COPD monographic consultation, Pneumology, Seville. PARTICIPANTS: Patients with a confirmed diagnosis of COPD in any degree. INTERVENTIONS: Clinical interview and measurement of carbon monoxide by cooximetry. MAIN MEASUREMENTS: Cooximetry values, responses on smoking, sociodemographic variables. RESULTS: n: 169. 107 patients presented values less than or equal to 6 ppm compared to 62 with values greater than 6 ppm, determining a prevalence of active smoking of 36.7%. The deception rate was 19.5% of the total sample (24.3% of all those who claimed not to smoke), with a Cohen kappa of 0.48 and p < 0.000. 40% of patients confessed not having told the truth. No relationship of this data was found with age, accumulated tobacco consumption or FEV1. A significant relationship with sex was found (deception rate: 31.8% in women vs. 15.2% in men, p 0.017). CONCLUSIONS: In spite of our attempts to make patients stop smoking, a considerable deception rate was found in our consultation; higher among women, recent ex-smokers or in the process of abandonment, so it would be essential to incorporate objective measures such as the cooximeter in the approach of this type of patient.