comorbilidades em doentes com doença pulmonar obstrutiva crónica estádio iv

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ID: 149691
2014
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Abstract
Resumo: Introdução: A doença pulmonar obstrutiva crónica (DPOC) está associada a várias comorbilidades, contudo, a prevalência das mesmas varia entre os estudos. Objetivo: Determinar a prevalência das diversas comorbilidades em doentes com DPOC estádio IV do The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2010, seguidos em regime de ambulatório, num hospital universitário. Métodos: Foi concebido e aplicado um questionário com o objetivo de caracterizar a DPOC e suas comorbilidades. Os dados foram completados por consulta do processo clínico. Resultados: Foram incluídos 89 doentes (87% do género masculino), com média etária de 68 anos, 79% dos quais ex-fumadores. O valor de volume expiratório máximo por segundo (VEMS) médio foi de 38% do previsto e todos os doentes apresentavam insuficiência respiratória crónica. Trinta e cinco doentes (39%) apresentavam exacerbações frequentes.Trinta e sete doentes (42%) tinham apresentado pelo menos um internamento por exacerbação da sua doença respiratória no ano anterior e 66 doentes (74%) nos últimos 5 anos.A maioria dos doentes (97%) apresentava pelo menos uma comorbilidade, com uma média de 4 comorbilidades por doente e um índice de Charlson médio de 2.As comorbilidades mais frequentes foram doenças cardiovasculares (69%), patologia osteoarticular (51%), disfunção erétil (48%), síndrome da apneia do sono (43%), dislipidémia (35%), cataratas (31%), refluxo gastro-esofágico (29%) e diabetes (20%).Os exacerbadores frequentes apresentaram um risco aumentado de terem 2 ou mais comorbilidades (Odds ratio de 5), bem como uma maior prevalência de refluxo gastro-esofágico (p = 0,006) e um maior número de internamentos no último ano e nos 5 anos anteriores (p < 0,001). Conclusão: Este estudo confirmou a elevada prevalência e a associação de comorbilidades em doentes com DPOC GOLD estádio IV, justificando a necessidade de uma abordagem terapêutica abrangente e integradora. Abstract: Introduction: Chronic Obstructive Pulmonary Disease (COPD) is associated with several co-morbidities, however their prevalence varies from one study to another. Aim: To determine the prevalence of several co-morbidities in patients with COPD severity score GOLD 4 (The Global Initiative for Chronic Obstructive Lung Disease, 2010) followed in ambulatory care, in a University Hospital. Methods: A questionnaire was designed and carried out in order to characterize COPD and its co-morbidities. Clinical files were consulted in order to complete the data. Results: 89 patients (87% male) with a mean age of 68 years old, of which 79% were ex-smokers, were included. The average value of FEV1 (forced expiratory volume in one second) was 38% of the expected values and all the patients presented chronic respiratory failure. Thirty-five patients (39%) were frequent exacerbators.Thirty-seven patients (42%) had been hospitalized at least once due to exacerbation of their respiratory disease in the previous year, and 66 patients (74%) hospitalized in the previous five years.Most of the patients (97%) presented at least one comorbidity, with an average of 4 co-morbidities per patient and an average Charlson index of 2.The most frequent co-morbidities were cardiovascular diseases (69%), osteoarticular pathology (51%), erectile dysfunction (48%), sleep apnoea syndrome (43%) dyslipidaemia (35%), cataracts (31%), gastroesophageal reflux (29%) and diabetes (20%).Frequent exacerbators presented an increased risk of having two or more co-morbidities (Odds Ratio of 5), as well as a higher prevalence of gastroesophageal reflux (p = 0.0006) and more hospitalizations in the last year and in the previous 5 years (p < 0.001). Conclusion: This study confirmed the high prevalence and the association of co-morbidities in patients with COPD severity score GOLD 4, thus justifying the need for a comprehensive and integrating therapeutic approach. Palavras-chave: Doença pulmonar obstrutiva crónica, Comorbilidades, Exacerbação, Keywords: Chronic obstructive pulmonary disease, Co-morbidities, Exacerbation
Reference Key
areias2014revistacomorbilidades Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;V. Areias;S. Carreira;M. Anciães;P. Pinto;C. Bárbara
Journal the journal of applied psychology
Year 2014
DOI
DOI not found
URL
http://www.sciencedirect.com/science/article/pii/S0873215913000317
Keywords
diseases of the respiratory system

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