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Arch Bronconeumol. 2014;50(1):10–17
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Original Article
A Population-Based Cohort Study on Chronic Obstructive Pulmonary Disease in Latin America: Methods and Preliminary Results. The PLATINO Study Phase II夽 ˜ b Maria Victorina López-Varela,c Ana Maria Baptista Menezes,a,∗ Adriana Muino, d d Gonzalo Valdivia, Carmen Lisboa, José Roberto Jardim,e Maria Montes de Oca,f Carlos Tálamo,f Fernando César Wehrmeister,a Rogelio Perez-Padillag , Equipo del estudio Platino♦ a
Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil Departamento de Neumología, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay c Facultad de Medicina, Universidad de la República, Montevideo, Uruguay d Escuela de Medicina, Universidad Católica de Santiago, Santiago, Chile e Departamento de Neumología, Federal University of São Paulo, São Paulo, Brazil f Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela g Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico b
a r t i c l e
i n f o
Article history: Received 29 April 2013 Accepted 2 July 2013 Available online 14 January 2014 Keywords: Chronic obstructive pulmonary disease Longitudinal studies Latin America
a b s t r a c t Background: The PLATINO baseline study, conducted from 2003 to 2005 in five Latin American cities (São Paulo, Mexico City, Montevideo, Santiago, Caracas), showed a high prevalence of chronic obstructive pulmonary disease (COPD). Methods/design: A follow-up study was conducted in three out of the five centers (Montevideo, Santiago, and São Paulo) after a period of 5, 6 and 9 years, respectively, aimed at verifying the stability of the COPD diagnosis over time, the evolution of the disease in terms of survival, morbidity and respiratory function, and the analyses of inflammatory and genetic biomarkers in the blood. Some questions were added to the original questionnaire and death certificates were obtained from the national official registries. Results: The fieldwork has been concluded in the three centers. From the original samples in the PLATINO study phase i, we were able to locate and interview 85.6% of patients in Montevideo, 84.7% in Santiago and 77.7% in São Paulo. Individuals who could not be located had higher education levels in Brazil, and were more likely to be current smokers in Santiago and São Paulo than in Montevideo. The overall quality of spirometries was ≥80% according to American Thoracic Society criteria. The number of deaths was 71 (Montevideo), 95 (Santiago) and 135 (São Paulo), with death certificates obtained from the national mortality registries for 76.1%, 88.3% and 91.8% of cases in Montevideo, Santiago and São Paulo, respectively. Conclusions: This study shows that it is possible to perform population-based longitudinal studies in Latin American with high follow-up rates and high-quality spirometry data. The adequacy of national mortality registries varies among centers in Latin America. © 2013 SEPAR. Published by Elsevier España, S.L. All rights reserved.
夽 Please cite this article as: Menezes AMB, Muino ˜ A, López-Varela MV, Valdivia G, Lisboa C, Jardim JR, et al. Estudio de cohorte de base poblacional sobre la enfermedad pulmonar obstructiva crónica en Latinoamérica: métodos y resultados preliminares. Fase II del estudio PLATINO. Arch Bronconeumol. 2014;50:10–17. ∗ Corresponding author. E-mail address:
[email protected] (A.M.B. Menezes). ♦ Team members are listed in Appendix 1. 1579-2129/$ – see front matter © 2013 SEPAR. Published by Elsevier España, S.L. All rights reserved.
Document downloaded from http://www.archbronconeumol.org day 22/06/2016. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited.
A.M.B. Menezes et al. / Arch Bronconeumol. 2014;50(1):10–17
11
Estudio de cohorte de base poblacional sobre la enfermedad pulmonar obstructiva crónica en Latinoamérica: métodos y resultados preliminares. Fase II del estudio PLATINO r e s u m e n Palabras clave: Enfermedad pulmonar obstructiva crónica Estudios longitudinales Latinoamérica
Antecedentes: El estudio basal del PLATINO, llevado a cabo entre 2003 y 2005 en 5 ciudades latinoamericanas (São Paulo, Ciudad de México, Montevideo, Santiago, Caracas), mostró una prevalencia elevada de la enfermedad pulmonar obstructiva crónica (EPOC). Métodos/dise˜ no: Se llevó a cabo un estudio de seguimiento en 3 de los 5 centros (Montevideo, San˜ respectivamente, con el objetivo de verificar tiago y São Paulo) después de un periodo de 5, 6 y 9 anos, la estabilidad del diagnóstico de EPOC a lo largo del tiempo, la evolución de la enfermedad en cuanto a supervivencia, morbilidad y función respiratoria, y análisis de los biomarcadores genéticos e inflamato˜ rios en sangre. Se anadieron algunas preguntas adicionales al cuestionario original y se obtuvieron los certificados de defunción a partir de los registros oficiales nacionales. Resultados: El trabajo de campo se ha completado en los 3 centros. De las muestras originales de la fase i del PLATINO pudimos localizar y entrevistar al 85,6% en Montevideo, al 84,7% en Santiago y al 77,7% en São Paulo. Los individuos no localizados se caracterizaban por un mayor nivel de estudios en Brasil y era más probable que fueran fumadores actuales en Santiago y São Paulo que en Montevideo. La calidad global de las espirometrías fue ≥ 80% según los criterios de la American Thoracic Society. El número de muertes fue de 71 (Montevideo), 95 (Santiago) y 135 (São Paulo), y se obtuvieron los certificados de defunción a partir de los registros de mortalidad nacionales del 76,1, del 88,3 y del 91,8% de los casos en Montevideo, Santiago y São Paulo, respectivamente. Conclusiones: Este estudio muestra que es posible realizar estudios longitudinales de base poblacional en Latinoamérica, con tasas de seguimiento elevadas y una alta calidad de los datos de espirometría. La idoneidad de los registros de mortalidad nacionales varía en los distintos centros de Latinoamérica. © 2013 SEPAR. Publicado por Elsevier España, S.L. Todos los derechos reservados.
Background Studies on the prevalence of COPD in Latin America (LA) are scarce; the PLATINO project was a multicenter study carried out in five centers in LA, filling an important gap of knowledge in this area.1 The original aim of the PLATINO study, launched in 2002, was to describe the epidemiology of COPD in five major LA cities: São Paulo (Brazil), Santiago (Chile), Mexico City (Mexico), Montevideo (Uruguay), and Caracas (Venezuela), among adults aged 40 years or more, since subjects less than 40 years of age have low prevalence of COPD.2 A secondary objective was to evaluate the prevalence of self-reported medical co-morbidities that can occur quite often with COPD, such as cardiovascular diseases and lung cancer. These sites represent the various different geographical areas of LA and the largest metropolitan area in each participating country. The study was conducted from 2002 to 2004 as an initiative from the Associación Latinoamericana del Tórax (ALAT). The PLATINO baseline study revealed a high prevalence of COPD in Latin America based on the fixed ratio criteria (FEV1/FVC 10 pack-years
373 27 116 368
Passive smoking No Yes
607 277
376 (82.8) 617 (85.8)
427 536
329 (82.9) 319 (84.6) 345 (86.5)
383 308 272
688 (84.4) 249 (86.8) 7 (58.3) 38 (79.2) 9 (100.0)
556 265 97 23 22
678 (85.1) 78 (90.7)
978 193
45 (88.2) 116 (85.3) 288 (83.5) 306 (87.7)
78 117 351 627
317 (85.0) 226 (87.6) 214 (84.6)
384 335 454
317 (85.0) 26 (96.3) 105 (90.5) 309 (84.0)
387 80 325 379
521 (85.8) 236 (85.2)
673 500
394 (84.4) 363 (87.1)
684 485
15 (100.0) 199 (82.2) 280 (85.6) 263 (87.7)
6 288 499 375
821 (84.0) 170 (88.1)
821 141
66 (84.6) 98 (83.8) 293 (83.5) 536 (85.5)
222 294 222 222
340 (88.5) 287 (85.7) 366 (80.6)
409 316 237
343 (88.6) 68 (85.0) 261 (80.3) 319 (84.2)
409 154 199 190
576 (85.6) 417 (83.4)
673 289
575 (84.1) 415 (85.6)
531 432
5 (83.3) 237 (82.3) 421 (84.4) 326 (86.9)
20 342 359 242
613 (74.7) 102 (72.3) 178 (80.2) 225 (76.5) 153 (68.9) 157 (70.7) P=.001 292 (71.4) 259 (82.0) 164 (69.2) P
