Valoración de la Concordancia en la Interpretación de las Alteraciones Espirométricas Obtenidas, según los Valores de Referencia Espirométricos KNUDSON 1983 y SER 2014, en personas atendidas en el Programa ERA del CESFAM Juan Bautista Bravo Vega, entre Mayo de 2012 y Mayo de 2014
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2014
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Universidad Andrés Bello
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Introducción: La espirometría es a nivel mundial, el examen de elección para la medición de la función pulmonar. Para la interpretación correcta de ésta, es necesario relacionar sus resultados con valores de referencia espirométricos (VRE) obtenidos a partir de sujetos sanos desde el punto de vista respiratorio, de igual género, edad y talla. En Chile aún no existe consenso en cuanto a que VRE utilizar, por lo que ha existido gran variabilidad al momento de interpretar una espirometría y determinar la alteración espirométrica de ésta. Según normas de la ATS Y ERS, los VRE debería provenir de la población a la cual se le aplicará el examen de función pulmonar. Es por ello que la Sociedad Chilena de Enfermedades Respiratorias (SER) en Febrero de 2014 publicó VRE representativos de la población chilena. El objetivo de esta investigación es describir y valorar la concordancia en las alteraciones espirométricas al ser interpretadas mediante los VRE Knudson 1983 y SER 2014.
Diseño: El presente trabajo corresponde a un estudio transversal, no experimental de tipo descriptivo - comparativo.
Escenario: CESFAM Juan Bautista Bravo Vega de la comuna de Villa Alemana, Quinta Región, Chile.
Método: Se interpretaron mediante los VRE Knudson 1983 y SER 2014, 379 espirometrías que cumplieron con los criterios de calidad SER (1988), de las cuales 90 correspondieron a hombres (rango 19-82 años) y 289 a mujeres (rango entre 19-87 años), pertenecientes al Programa de Enfermedades Respiratorias del Adulto (ERA) del CESFAM Juan Bautista Bravo Vega, de la comuna de Villa Alemana, Región de Valparaíso, Chile. Las espirometrías fueron clasificadas según alteración espirométrica (Normal, Obstructiva y Restrictiva). Para el análisis estadístico fue utilizado el coeficiente Kappa de Cohen (ϰ), valorado según lo propuesto por Landis y Koch (1977).
Resultados: La concordancia en la interpretación de la alteración espirométrica entre los VRE Knudson 1983 y SER 2014 para la muestra completa fue de ϰ=0,656 (IC 95% 0,582-0,731). Para los hombres fue de ϰ=0,744 (IC 95% 0,614-0,874), mientras que para las mujeres la concordancia fue de ϰ=0,622 (IC 95% 0,532-0,711).
Al establecer dos rangos etarios por género, se observó que los hombres en el rango 19-50 años presentaron una concordancia ϰ=0,521 (IC 95% 0,214 - 0,827), mientras que para el rango 51-82 años fue de ϰ= 0,811 (IC 95% 0,675-0,946)
Por su parte, las mujeres en el rango 19-53 años presentaron una concordancia de ϰ=0,474 (IC 95% 0,231-0,716), mientras que para el rango 54-87 años fue de ϰ=0,618 (IC 95% 0,516-0,720).
Conclusión: La concordancia en la interpretación de la alteración espirométrica entre los VRE Knudson 1983 y SER 2014 tanto para la muestra completa, como para hombres y mujeres por separado, fue valorada como significativa (fuerza de concordancia considerable). Al analizar ambos géneros según rango etario, se observó que la concordancia más baja del estudio se presenta en las mujeres del rango entre 19-53 años de edad valorada como "moderada", mientras que la más alta se observa en los hombres pertenecientes al rango entre 51-82 años de edad, valorada como "casi perfecta".
Introduction: Spirometry is, globally, the test of choice for measurement of lung function. For the correct interpretation of this, it is necessary to relate their results with Spirometric Reference Values (SRV) obtained from healthy subjects from the point of view of respiratory, same gender, age and size. In Chile there is still no consensus as to which SRV use, so it has been a big variability when interpreting spirometry and determine the spirometric alteration. According to norms of the ATS and ERS, the SVR should come from the population which will apply the test of lung function. Therefore, the Chilean Society of Respiratory Diseases (SER) in February of 2014 published a representative of the Chilean population SRV. The objective of this investigation is to describe and assess the concordance in the spirometry alterations to be interpreted by the SVR Knudson 1983 and SER 2014. Design: The present study corresponds to a transverse, non-experimental study of descriptive - comparative. Stage: CESFAM Juan Bautista Bravo Vega of the commune of Villa Alemana, Fifth Region, Chile. Method: Were interpreted by the SVR Knudson 1983 and SRD 2014, 379 spirometry which met the criteria of quality SER (1988), 90 belonged to men (range 19-82 years) and 289 to women (range 19-87 years). They were belonged to the program diseases respiratory of the adult (ERA) of the CESFAM Juan Bautista Bravo Vega, of the commune of Villa Alemana, Region of Valparaiso, Chile. The spirometries were classified according to alteration spirometry (Normal, obstructive and Restrictive). For the statistical analysis was used the coefficient Kappa of Cohen (ϰ), valued as proposed by Landis and Koch (1977). Results: The concordance of spirometric alterations between the SVR Knudson 1983 and SER 2014 for the full sample was ϰ = 0, 656 (95% CI 0, 582-0, 731). For men it was ϰ = 0, 744 (95% CI 0, 614-0, 874), while for women the concordance was ϰ = 0, 622 (95% CI 0, 532-0, 711). To stablish two age ranges by gender, it was observed that men in the range 19-50 years presented a concordance ϰ = 0, 521 (95% CI 0,214 - 0,827), while the range 51-82 years was ϰ = 0.811 (95% CI 0, 675-0, 946). Moreover, women in the range 19-53 years had a concordance of ϰ = 0, 474 (95% CI 0, 231-0, 716), while for the range 54-87 years was ϰ = 0, 618 (95% CI 0, 516-0, 720). Conclusion: The concordance in spirometric alteration between SVR Knudson 1983 and SER 2014 for the full sample, for men and women separately, was valued as meaningful (force of considerable concordance). Analyzing both genres according to age range, was observed lower study concordance is presented in the women of the range between 19-53 years old was valued as "moderate", while the highest is observed in men belonging to the range between 51-82 years old, valued as "almost perfect".
Introduction: Spirometry is, globally, the test of choice for measurement of lung function. For the correct interpretation of this, it is necessary to relate their results with Spirometric Reference Values (SRV) obtained from healthy subjects from the point of view of respiratory, same gender, age and size. In Chile there is still no consensus as to which SRV use, so it has been a big variability when interpreting spirometry and determine the spirometric alteration. According to norms of the ATS and ERS, the SVR should come from the population which will apply the test of lung function. Therefore, the Chilean Society of Respiratory Diseases (SER) in February of 2014 published a representative of the Chilean population SRV. The objective of this investigation is to describe and assess the concordance in the spirometry alterations to be interpreted by the SVR Knudson 1983 and SER 2014. Design: The present study corresponds to a transverse, non-experimental study of descriptive - comparative. Stage: CESFAM Juan Bautista Bravo Vega of the commune of Villa Alemana, Fifth Region, Chile. Method: Were interpreted by the SVR Knudson 1983 and SRD 2014, 379 spirometry which met the criteria of quality SER (1988), 90 belonged to men (range 19-82 years) and 289 to women (range 19-87 years). They were belonged to the program diseases respiratory of the adult (ERA) of the CESFAM Juan Bautista Bravo Vega, of the commune of Villa Alemana, Region of Valparaiso, Chile. The spirometries were classified according to alteration spirometry (Normal, obstructive and Restrictive). For the statistical analysis was used the coefficient Kappa of Cohen (ϰ), valued as proposed by Landis and Koch (1977). Results: The concordance of spirometric alterations between the SVR Knudson 1983 and SER 2014 for the full sample was ϰ = 0, 656 (95% CI 0, 582-0, 731). For men it was ϰ = 0, 744 (95% CI 0, 614-0, 874), while for women the concordance was ϰ = 0, 622 (95% CI 0, 532-0, 711). To stablish two age ranges by gender, it was observed that men in the range 19-50 years presented a concordance ϰ = 0, 521 (95% CI 0,214 - 0,827), while the range 51-82 years was ϰ = 0.811 (95% CI 0, 675-0, 946). Moreover, women in the range 19-53 years had a concordance of ϰ = 0, 474 (95% CI 0, 231-0, 716), while for the range 54-87 years was ϰ = 0, 618 (95% CI 0, 516-0, 720). Conclusion: The concordance in spirometric alteration between SVR Knudson 1983 and SER 2014 for the full sample, for men and women separately, was valued as meaningful (force of considerable concordance). Analyzing both genres according to age range, was observed lower study concordance is presented in the women of the range between 19-53 years old was valued as "moderate", while the highest is observed in men belonging to the range between 51-82 years old, valued as "almost perfect".
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Tesis (Kinesiología)
Palabras clave
Pruebas de Función Respiratoria, Neumopatías Obstructivas, Espirometría, Sociedad Chilena