Calidad de las espirometrías realizadas en las unidades de atención primaria de la provincia de Guipúzcoa

ObjetivoDeterminar la validez de las espirometrías realizadas en atención primaria en nuestra provincia y conocer en qué aspectos de la maniobra se cometen los errores.DiseñoEstudio descriptivo, transversal.EmplazamientoProvincia de Guipúzcoa.ParticipantesParticiparon 30 de las 44 unidades existentes aportando las últimas 10 espirometrías.Mediciones principalesDos médicos de atención primaria analizaron las espirometrías siguiendo los criterios de validez de la American Thoracic Society. Un neumólogo revisó los resultados no coincidentes.ResultadosDe las 300 espirometrías analizadas se excluyeron 12 por ser ilegibles. El 48% fueron aceptables, un 78% reunía criterios de reproducibilidad y un 38,5% reunía ambas características. El patrón más habitual era el normal con un 58%, seguido del restrictivo con un 18%, el obstructivo un 13% y el mixto un 11%. El error más frecuente (38,19%) era la escasa prolongación de la espiración.ConclusionesLa calidad de las espirometrías realizadas en atención primaria es deficiente. El error más frecuente es la brevedad de la espiración, por ello encontramos un predominio de patrones restrictivos. Simplemente prolongando la maniobra espiratoria se conseguiría aumentar considerablemente el número de espirometrías válidas.

ObjectiveTo determine the validity of Spirometry tests done in primary care in our province and to find in what parts of the test errors are committed.DesignTransversal, descriptive study.SettingAll the primary care units in the province of Gipuzkoa, Spain.ParticipantsThirty of the 44 existing units took part, contributing the last 10 spirometry tests conducted in November, 2005.Main measurementsTwo primary care doctors who were skilled in spirometry analysed the acceptability, reproducibility, possible utility of invalid tests and their spirometric patterns. They also looked at aspects of the curve that were not sufficient. Tests were considered acceptable, reproducible and possibly useful when the 2 doctors coincided. Where they did not coincide, these characteristics were determined by a pneumologist. The validity criteria of the ATS were followed.ResultsOf the 44 units in our province, 30 took part. They contributed 300 spirometry tests, of which 12 were excluded as illegible. A total of 48% were considered acceptable, 78% met reproducibility criteria and 38.5% met both characteristics. The most common error was the scant length of exhalation, insufficient in 38.19% of cases. The most usual pattern found was the normal one with 58%, followed by the restrictive with 18%, the obstructive with 13%, and the mixed one, with 11%.ConclusionsQuality of spirometry tests in primary care is deficient. The most common error is that exhalation is too brief. We think this is why we find a predominance of restrictive patterns over obstructive ones. Just by prolonging the spirometry operation, we would manage to increase markedly the number of valid tests.