¿Cuán inocuos son los síntomas respiratorios crónicos en relación con la discapacidad? Análisis en un estudio poblacional, encuesta nacional de salud 2009-10*

Abstract

Background: Chronic respiratory diseases are characterized by chronic respiratory symptoms (CRS) and extrapulmonary manifestations, such as muscle loss and depression. The prevalence of global disability among people with these diseases is estimated to range from 14.7 to 36%. Objective: To quantify the contribution of CRS to disability. Materials and Methods: We analyzed data from the 2009-10 National Health Survey, which is representative at the national, regional, and urban-rural levels for adults. The CRS questionnaire identified four primary symptoms: chronic cough/sputum, re­current wheezing, and dyspnea. Symptoms were grouped into phenotypes and categorized by suspected depression. Disability was measured on a scale from 0 (no disability) to 100 (maximum disability). Li­near regression models were applied, adjusting for confounding variables. Results: All CRS phenotypes were associated with disability. Individuals with four CRS had an adjusted disability score 9.45 points higher (4.93-13.96) than those without CRS. Those with dyspnea showed an adjusted score increase of 7.22 (6.10-8.34), emphasizing its individual contribution to disability. Participants with four CRS and depression, as well as those reporting dyspnea with depression, showed the highest adjusted scores: 16.20 (14.28-18.11) and 20.04 (12.12-27.95), respectively. Additionally, individuals with chronic bron­chitis and high physical activity levels had lower predicted disability scores. Conclusions: This study emphasizes the clinical significance of CRS in contributing to disability and enhances the weighting of this component in future burden of disease studies. Population studies with objective pulmonary function measurements are essential for a better understanding.