Evolução dos marcadores diagnósticos e prognósticos de pacientes com DPOC no período de três anos
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Data
2010-02-25
Autores
Ferrari, Renata [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Estudos mostram a evolução dos marcadores locais e sistêmicos da doença pulmonar obstrutiva crônica (DPOC) e sua associação com o prognóstico da doença. No entanto, não identificamos estudos prévios avaliando a evolução desses marcadores em pacientes brasileiros com DPOC. Além disso, a associação entre as modificações dos marcadores da doença e a qualidade de vida relacionada à saúde não está clara. O objetivo deste estudo foi verificar a evolução dos marcadores diagnósticos e prognósticos de pacientes com DPOC e a associação destes marcadores com a mortalidade, exacerbação e modificações na qualidade de vida relacionada à saúde no período de três anos. No momento basal foram avaliados 133 pacientes com DPOC leve a muito grave, 15 pacientes (11%) morreram durante o seguimento e 23 pacientes (17%) não foram reavaliados. Portanto, 95 pacientes (72%) foram submetidos às seguintes avaliações no momento basal e após três anos: espirometria, composição corporal, sensação da dispneia por meio da escala Medical Research Council (MRC) e do índice de dispneia basal (BDI), qualidade de vida por meio do Questionário do Hospital Saint George na Doença Respiratória (SGRQ), comorbidades (Índice Charlson), tolerância ao exercício (distância percorrida em seis minutos-DP6) e cálculo do Índice BODE. Após a avaliação inicial, os pacientes ou seus familiares foram contatados a cada três meses para verificar a frequência de exacerbações e óbito. A evolução dos marcadores foi feita por meio do teste T para medidas repetidas. Análise de regressão de Cox foi realizada para identificar os preditores de mortalidade. A associação dos marcadores da doença com a frequência de exacerbação foi avaliada por meio da análise de regressão de Poisson. Análise de regressão logística foi utilizada para avaliar...
Studies show the evolution of local and systemic markers of chronic obstructive pulmonary disease (COPD) and its association with the disease prognosis. However, we did not identify previous studies evaluating the evolution of these markers in Brazilian patients with COPD. In addition, the association between modifications in disease markers and health-related quality of life (HRQL) are unclear. The objective of this study was to verify the evolution of diagnostic and prognostic markers in COPD patients and the association of these markers with mortality, exacerbation and modifications in HRQL over three years. At baseline were evaluated 133 patients with mild to very severe COPD, 15 patients (11%) died and 23 patients (17%) dropped out during the follow-up period. Therefore, 95 patients (72%) underwent following the evaluations at baseline and after three years: spirometry, body composition, dyspnea perception using the Medical Research Council scale (MRC) and the baseline dyspnea index (BDI), quality of life questionnaire by Saint George's Respiratory Questionnaire (SGRQ), comorbidities (Charlson index), exercise tolerance (six-minute walk distance-6MWD) and the calculate BODE index. After the initial assessment, patients or their relatives were contacted every three months to verify the exacerbations frequency and death. The evolution of the markers was evaluated using the paired t-test. Cox regression analysis was performed to identify mortality predictors. Association of disease markers with exacerbation frequency was assessed by Poisson regression analysis. Logistic regression analysis was used to evaluate the predictors of improvement or worsening of HRQL. After three years of study, there was no change in the values of FEV1 (p=0.23) and BMI (p=0.38). There was a significant worsening... (Complete abstract click electronic access below)
Studies show the evolution of local and systemic markers of chronic obstructive pulmonary disease (COPD) and its association with the disease prognosis. However, we did not identify previous studies evaluating the evolution of these markers in Brazilian patients with COPD. In addition, the association between modifications in disease markers and health-related quality of life (HRQL) are unclear. The objective of this study was to verify the evolution of diagnostic and prognostic markers in COPD patients and the association of these markers with mortality, exacerbation and modifications in HRQL over three years. At baseline were evaluated 133 patients with mild to very severe COPD, 15 patients (11%) died and 23 patients (17%) dropped out during the follow-up period. Therefore, 95 patients (72%) underwent following the evaluations at baseline and after three years: spirometry, body composition, dyspnea perception using the Medical Research Council scale (MRC) and the baseline dyspnea index (BDI), quality of life questionnaire by Saint George's Respiratory Questionnaire (SGRQ), comorbidities (Charlson index), exercise tolerance (six-minute walk distance-6MWD) and the calculate BODE index. After the initial assessment, patients or their relatives were contacted every three months to verify the exacerbations frequency and death. The evolution of the markers was evaluated using the paired t-test. Cox regression analysis was performed to identify mortality predictors. Association of disease markers with exacerbation frequency was assessed by Poisson regression analysis. Logistic regression analysis was used to evaluate the predictors of improvement or worsening of HRQL. After three years of study, there was no change in the values of FEV1 (p=0.23) and BMI (p=0.38). There was a significant worsening... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Pneumopatias obstrutivas, Severity of illness index, Chronic obstructive pulmonary disease, Prognosis
Como citar
FERRARI, Renata. Evolução dos marcadores diagnósticos e prognósticos de pacientes com DPOC no período de três anos. 2010. 75 f. Dissertação (mestrado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2010.