Fatores associados à ocorrência de exacerbação em pacientes com DPOC
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Data
2007-03-16
Autores
Faganello, Marcia Maria [UNESP]
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ISSN da Revista
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Nos últimos anos, vários estudos avaliaram os marcadores da doença associados à freqüência de exacerbação, hospitalização, readmissão e mortalidade em pacientes portadores de doença pulmonar obstrutiva crônica (DPOC). Entretanto, estudos que avaliaram os marcadores associados à ocorrência de exacerbação em pacientes ambulatoriais são limitados. Assim, o objetivo deste estudo foi identificar os fatores de predição da ocorrência de exacerbação no período de um ano em 120 pacientes com DPOC atendidos no Ambulatório de Pneumologia da Faculdade de Medicina de Botucatu - Unesp. Os pacientes tiveram o diagnóstico de DPOC confirmado e foram submetidos às seguintes avaliações: espirometria pré e pós-broncodilatador, composição do corpo (antropometria e bioimpedância), qualidade de vida por meio do Saint George s Respiratory Questionnaire (SGRQ), intensidade da dispnéia por meio da escala modificada Medical Research Council (MMRC) e do índice basal de dispnéia (BDI) e tolerância ao exercício (distância percorrida em 6 minutos DP6). Em seguida foi calculado o índice BODE de acordo com os pontos de corte do volume expiratório no primeiro segundo (VEF1), do índice de massa do corpo, do MMRC e da DP6. Durante o período de acompanhamento de um ano, 60 pacientes (50%) apresentaram pelo menos um episódio de exacerbação da doença e, em conseqüência da agudização, 25 pacientes foram hospitalizados. Comorbidades extra-pulmonares foram causa de hospitalização em oito pacientes e de óbito em cinco pacientes. Na avaliação inicial, os pacientes que exacerbaram tinham maior comprometimento da função pulmonar e da troca gasosa, valores mais elevados do índice BODE e maior proporção de pacientes com DPOC III e IV. Além disso, apresentavam menores valores de DP6, maior sensação de dispnéi...
Markers of disease severity have been associated with mortality, occurrence and frequency of hospitalization and readmission due disease exacerbation in chronic obstructive pulmonary disease (COPD) patients. However, information about predictor factors for the occurrence of exacerbation in ambulatory COPD patients is scarce. Therefore, the aim of the present study was to identify predictor factors for the occurrence of exacerbation in 120 patients with COPD followed during one year in the outpatient clinic at Universidade Estadual Paulista (UNESP, Paulista State University) School of Medicine at Botucatu, located in the State of São Paulo, Brazil. The patients had the diagnosis of COPD confirmed and underwent to the following evaluations: pre- and postbronchodilator spirometry, body composition (anthropometry and bioimpedance), health-related quality of life (Saint George s Respiratory Questionnaire -SGRQ), dyspnea scores (Medical Research Council MMRC and basal dispnea index -BDI) and exercise tolerance (6MWD). Bode index was calculated taking in consideration the cutt off points for forced volume in the first second (FEV1), body mass index, MMRC and 6MWD. During the followup period 60 patients (50%) presented at least one exacerbation episode and, as consequence, 25 patients were hospitalized. Eight patients were hospitalized and five died due to non-pulmonary comorbidities. At baseline, patients with exacerbations during the follow-up period presented lower values of airway obstruction indexes and of arterial blood gases and higher values of BODE score and proportion of COPD patients class III and IV. In addition, the values of 6MWD were lower, dyspnea sensation was higher and the health- related quality of life was more deteriorated in these patients. No significative associations were found between gender, corticosteroid use... (Complete abstract click electronic access below)
Markers of disease severity have been associated with mortality, occurrence and frequency of hospitalization and readmission due disease exacerbation in chronic obstructive pulmonary disease (COPD) patients. However, information about predictor factors for the occurrence of exacerbation in ambulatory COPD patients is scarce. Therefore, the aim of the present study was to identify predictor factors for the occurrence of exacerbation in 120 patients with COPD followed during one year in the outpatient clinic at Universidade Estadual Paulista (UNESP, Paulista State University) School of Medicine at Botucatu, located in the State of São Paulo, Brazil. The patients had the diagnosis of COPD confirmed and underwent to the following evaluations: pre- and postbronchodilator spirometry, body composition (anthropometry and bioimpedance), health-related quality of life (Saint George s Respiratory Questionnaire -SGRQ), dyspnea scores (Medical Research Council MMRC and basal dispnea index -BDI) and exercise tolerance (6MWD). Bode index was calculated taking in consideration the cutt off points for forced volume in the first second (FEV1), body mass index, MMRC and 6MWD. During the followup period 60 patients (50%) presented at least one exacerbation episode and, as consequence, 25 patients were hospitalized. Eight patients were hospitalized and five died due to non-pulmonary comorbidities. At baseline, patients with exacerbations during the follow-up period presented lower values of airway obstruction indexes and of arterial blood gases and higher values of BODE score and proportion of COPD patients class III and IV. In addition, the values of 6MWD were lower, dyspnea sensation was higher and the health- related quality of life was more deteriorated in these patients. No significative associations were found between gender, corticosteroid use... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Aparelho respiratorio - Doença, Dispneia, Doença pulmonar obstrutiva crônica (DPOC), Chronic obstructive pulmonary disease (COPD), Respiratory organs - Diseases
Como citar
FAGANELLO, Marcia Maria. Fatores associados à ocorrência de exacerbação em pacientes com DPOC. 2007. 75 f. Tese (doutorado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2007.