Avaliação das sssociações entre tratamento farmacológico e diferentes classes de comorbidades em pacientes com Doença Pulmonar Obstrutiva Crônica
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Data
2021-04-15
Autores
Dainesi, Marcelo Alvares
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Universidade Estadual Paulista (Unesp)
Resumo
Avaliação das associações entre tratamento farmacológico e diferentes classes de comorbidades em pacientes com Doença Pulmonar Obstrutiva Crônica. 2021. 80 f. Dissertação (Mestrado em Fisiopatologia em Clínica Médica) – Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, 2021. Introdução: A Doença Pulmonar Obstrutiva Crônica (DPOC) é a terceira principal causa de morte no mundo, segundo a Organização Mundial de Saúde. O tratamento farmacológico adequado é importante para seu controle, melhora dos sintomas, diminuição de exacerbações, minimizando a perda progressiva da função pulmonar e diminuindo a mortalidade. Não há muitos dados na literatura avaliando as associações dos fármacos respiratórios às comorbidades e seus desfechos clínicos. Objetivo: Avaliar o tratamento farmacológico respiratório em diferentes comorbidades de pacientes com DPOC. Métodos: Foram avaliados 313 pacientes com DPOC de acordo com a classificação GOLD 2020. Foram submetidos à avaliação inicial composta por identificação pessoal, comorbidades associadas, índice de massa corpórea, fármacos atuais, história tabágica, oximetria de pulso e histórico de exacerbações/hospitalizações no último ano. Foram realizados exames de espirometria, hemograma, teste de caminhada de seis minutos, questionários de qualidade de vida, avaliação da dispneia, índice de comorbidades e escala hospitalar de ansiedade e depressão. Resultados: Pacientes com comorbidades metabólicas fazem maior uso de monoterapia e menor uso de terapia tripla do que pacientes sem estas comorbidades. Neutrófilos e eosinófilos estavam aumentados em pacientes com comorbidades cardiovasculares e metabólicas. O Índice COTE demonstrou maior risco de morte em pacientes com comorbidades cardiovasculares e menor em pacientes com comorbidades psiquiátricas. Conclusão: Pacientes com DPOC, com comorbidades metabólicas, fazem maior uso de monoterapia e menor uso de terapia tripla, comparados às demais comorbidades. Destacamos também aumento significativo de neutrófilos e eosinófilos em algumas comorbidades, como cardiovasculares e metabólicas, quando associadas à DPOC.
Evaluation of the associations between pharmacological treatment and different classes of comorbidities in patients with Chronic Obstructive Pulmonary Disease. 2021. 80 f. Thesis (Master's in Pathophysiology in Clinical Medicine) – Faculty of Medicine of Botucatu, Universidade Estadual Paulista, Botucatu, 2021. Introduction: Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death in the world, according to the World Health Organization. Adequate pharmacological treatment is important for its control, improvement of symptoms, reduction of exacerbations, minimizing progressive loss of lung function and decreasing mortality. There is not much data in the literature evaluating the associations of respiratory drugs with comorbidities and their clinical outcomes. Objective: To evaluate respiratory pharmacological treatment in different comorbidities of patients with COPD. Methods: We evaluated 313 patients with COPD according to the GOLD 2020 classification. They were submitted to initial evaluation composed of personal identification, associated comorbidities, body mass index, current drugs, smoking history, pulse oximetry and history of exacerbations/hospitalizations in the last year. Spirometry, blood count, six-minute walk test, quality of life questionnaires, dyspnea assessment, comorbidity index and hospital anxiety and depression scale were performed. Results: Patients with metabolic comorbidities make greater use of monotherapy and less use of triple therapy than patients without these comorbidities. Neutrophils and eosinophils were increased in patients with cardiovascular and metabolic comorbidities. The COTE Index showed a higher risk of death in patients with cardiovascular comorbidities and lower in patients with psychiatric comorbidities. Conclusion: Patients with COPD, with metabolic comorbidities, make greater use of monotherapy and less use of triple therapy, compared to other comorbidities. We also highlight a significant increase in neutrophils and eosinophils in some comorbidities, such as cardiovascular and metabolic, when associated with COPD.
Evaluation of the associations between pharmacological treatment and different classes of comorbidities in patients with Chronic Obstructive Pulmonary Disease. 2021. 80 f. Thesis (Master's in Pathophysiology in Clinical Medicine) – Faculty of Medicine of Botucatu, Universidade Estadual Paulista, Botucatu, 2021. Introduction: Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death in the world, according to the World Health Organization. Adequate pharmacological treatment is important for its control, improvement of symptoms, reduction of exacerbations, minimizing progressive loss of lung function and decreasing mortality. There is not much data in the literature evaluating the associations of respiratory drugs with comorbidities and their clinical outcomes. Objective: To evaluate respiratory pharmacological treatment in different comorbidities of patients with COPD. Methods: We evaluated 313 patients with COPD according to the GOLD 2020 classification. They were submitted to initial evaluation composed of personal identification, associated comorbidities, body mass index, current drugs, smoking history, pulse oximetry and history of exacerbations/hospitalizations in the last year. Spirometry, blood count, six-minute walk test, quality of life questionnaires, dyspnea assessment, comorbidity index and hospital anxiety and depression scale were performed. Results: Patients with metabolic comorbidities make greater use of monotherapy and less use of triple therapy than patients without these comorbidities. Neutrophils and eosinophils were increased in patients with cardiovascular and metabolic comorbidities. The COTE Index showed a higher risk of death in patients with cardiovascular comorbidities and lower in patients with psychiatric comorbidities. Conclusion: Patients with COPD, with metabolic comorbidities, make greater use of monotherapy and less use of triple therapy, compared to other comorbidities. We also highlight a significant increase in neutrophils and eosinophils in some comorbidities, such as cardiovascular and metabolic, when associated with COPD.
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Palavras-chave
DPOC, Comorbidade, Tratamento farmacológico, COPD, Comorbidities, Pharmacological Treatment