Pronóstico pesimista en EPOC y ASMA

"Prognostic pessimism" in asthma and COPD

S McCarthy

Correspondence to:

Dr S McCarthy, Foundation Year 2, Queen’s Hospital, Romford, Essex RM7 0AG, UK; smccarthy@doctors.org.uk

Doctors can be pessimistic—especially when making a prognosis—and this in turn may influence clinical decisions. This study looked at the accuracy of the predicted outcome in patients with chronic obstructive pulmonary disease (COPD) and asthma with regard to admission to the intensive care unit (ITU).

Data were collected over 18 months from nearly half the ITUs involved in the UK Case Mix Program and three high dependency units. Patients aged <45> hospitals or within 10 days of surgery were excluded. In the 832 patients who were recruited, the primary outcome analysed was the comparison between the prediction for survival on admission and the actual outcome at 180 days. It was found that, overall, the admitting doctor underestimated the survival potential, especially in patients already in poor health. In fact, 40% of patients with the worst prognosis survived when only 10% had been predicted . . . [Full text of this article]