H
ospitalization
due
to
exacerbation
of
COPD: “R
eal
-
life
”
outcomes
R
ev
A
ssoc
M
ed
B
ras
2017; 63(6):543-549
549
que ordenamos em três
clusters
de acordo com idade, VEF
1
,
índice de massa corporal (IMC) e CAT. Os
clusters
não se
correlacionaram com os principais desfechos.
Conclusão:
A eDPOC é causa frequente de internações.
Foram frequentes as reinternações e estas se correlacionaram
com o desfecho óbito. Os pacientes internados por eDPOC
formaram um grupo heterogêneo, que pôde ser agrupado
em três
clusters
com diferentes graus de gravidade e sem
correlação com os desfechos das hospitalizações.
Keywords:
hospitalização por exacerbação da DPOC,
exacerbação da DPOC, teste de avaliação da DPOC, Escala
Analógica Visual, morte por DPOC.
R
eferences
1.
Projeto Latino-Americano de Investigação e Obstrução Pulmonar. PLATINO.
Brasil. Available from:
http://www.platino-alat.org.
2.
Moreira GL, Manzano BM, Gazzotti MR, Nascimento OA, Perez-Padill R,
Menezes AMB et al. PLATINO, a nine-year follow-up study of COPD in the
city of São Paulo, Brazil: the problem of underdiagnosi. J Bras Pneumol.
2014; 40(1):30-7.
3. Global Initiative for Chronic Obstructive Lung Disease (Updated 2015).
Available from:
http://goldcopd.it/wp-content/uploads/materiali/2015/Gold_Pocket_DEF_2015.pdf
4. Toyoshima MTK, Ito GM, Gouveia N. Morbidades por doenças respiratórias
em pacientes hospitalizados em São Paulo/SP. Rev Assoc Med Bras. 2005;
51(4):209-13.
5. Brasil. Ministério da Saúde. Departamento de Informática do SUS. Brasília
(DF): DATASUS; 2010. Available from:
http://www2.datasus.gov.br/DATASUS/index.php. Cited in “Protocolo Clínico e Diretrizes Terapêuticas (PCDT) –
Doença Pulmonar Obstrutiva Crônica”, regulamentado pela PORTARIA Nº
609, 6 de junho de 2013, doMinistério da Saúde Secretaria de Atenção à Saúde.
CONITEC Comissão Nacional de Incorporação de Tecnologias ao SUS.
6. Divo M, Cote C, Torres JP, Casanova C, Marin JM, Pinto-Plata V, et al.; BODE
CollaborativeGroup.Comorbiditiesandriskofmortality inpatientswithchronic
obstructive pulmonary disease. Am J Respir Crit CareMed. 2012; 186(2):155-61.
7.
Nussbaumer-Ochsner Y, Rabe KF. Systemic manifestations of COPD. Chest.
2011; 139(1):165-73.
8.
Maurer J, Rebbapragada V, Borson S, Goldstein R, Kunik ME, Yohannes AM,
et al. Anxiety and depression in COPD: current understanding, unanswered
questions, and research needs. Chest. 2008; 134(4 Suppl):43s-56s.
9.
Botega NJ, Bio MR, Zomignani MA, Garcia Jr C, Pereira WAB. Transtornos
do humor em enfermaria de clínica médica e validação de escala de medida
(HAD) de ansiedade e depressão. Rev Saúde Pública. 1999; 29(5):355-63.
10. Camargo LACR, Pereira CAC. Dispneia em DPOC: além da escala modified
Medical Research Council. J Bras Pneumol. 2010; 36(5):571-8.
11.
Jones PW, Harding G, Berry P, Wiklund I, Chen WH, Kline Leidy NK.
Development and first validation of the COPD Assessment Test. Eur Respir
J. 2009; 34(4):648-54.
12.
Mackay AJ, Donaldson GC, Patel ARC, Jones PW, Hurst JR, Wedzicha JA.
Usefulness of the Chronic Obstructive Pulmonary Disease Assessment Test
to evaluate severity of COPD exacerbations. Am J Respir Crit Care Med.
2012; 185(11):1218-24.
13.
Silva GPFS, Morano MTAP, Viana CMS, Magalhães CBA, Pereira EDB.
Portuguese-language version of the COPD Assessment Test: validation for
use in Brazil. J Bras Pneumol. 2013; 39(4):402-8.
14. Quon BS, GanWQ, SinDD. Contemporary management of acute exacerbations
of COPD: a systematic review and metaanalysis. Chest. 2008; 133(3):756-66.
15.
Marchiori RC, Susin CF, Dal Lago L, Felice CD, Brandão da Silva D, Severo
MD. Diagnóstico e tratamento da DPOC exacerbada na emergência. AMRIGS
(Porto Alegre). 2010; 54(2):214-23.
16.
Bafadhel M, McKenna S, Terry S, Mistry V, Pancholi M, Veng P, et al. Blood
eosinophils to direct corticosteroid treatment of exacerbations of chronic
obstructive pulmonary disease: a randomized placebo-controlled trial. Am
J Respir Crit Care Med. 2012; 186(1):48-55.
17. Chen YW, Leung JM, Sin DD. A systematic review of diagnostic biomarkers
of COPD exacerbation. PLoS One. 2016; 11(7):e0158843.
18.
Price D, Crockett A, Arne M, Garbe B, Jones R, Kaplan A, et al. Spirometry
in primary care case-identification, diagnosis and management of COPD.
Prim Care Respir J. 2009; 18(3):216-23.
19.
Fromer L. Diagnosing and treating COPD: understanding the challenges
and finding solutions. Int J Gen Med. 2011; 4:729-39.
20. Tan WC, Sin DD, Bourbeau J, Hernandez P, Chapman KR, Cowie R, et al.;
CanCOLD Collaborative Research Group. Characteristics of COPD in never-
smokers and ever-smokers in the general population: results from the
CanCOLD study. Thorax. 2015; 70(9):822-9.
21.
Fu JJ, Gibson PG, Simpson JL, McDonald VM. Longitudinal changes in
clinical outcomes in older patients with asthma, COPD and asthma-COPD
Overlap Syndrome. Respiration. 2014; 87(1):63-74.
22.
Diagnosis of Diseases of Chronic Airflow Limitation: Asthma, COPD
and Asthma-COPD Overlap Syndrome (ACOS). A joint project of GINA
and GOLD 2014. This chapter is excerpted from the Global Strategy for
Asthma Management and Prevention, 2014. Available from: http://www.
ginasthma.org.23. Turner AM, Tamasi L, Schleich F, Hoxha M, Horvath I, Louis R, et al.
Clinically relevant subgroups in COPD and asthma. Eur Respir Rev. 2015;
24(136):283-98.
24.
Echave-Sustaeta JM, Comeche Casanova L, Cosio BG, Soler-Cataluña JJ,
Garcia-Lujan R, Ribera X. Comorbidity in chronic obstructive pulmonary
disease. Related to disease severity? Int J Chron Obstruct Pulomon Dis.
2014; 9:1307-14.
25.
Jeong SH, Lee H, Carriere KC, Shin SH, Moon SM, Jeong BH, et al.
Comorbidity as a contributor to frequent severe acute exacerbation in COPD
patients. Int J Chron Obstruct Pulmon Dis. 2016; 11:1857-65.
26.
Miravitlles M, Moragas A, Hernández S, Bayona C, Llor C. Is it possible to
identify exacerbations of mild to moderate COPD that do not require
antibiotic treatment? Chest. 2013; 144(5):1571-7.
27.
Hurst JR, Vestbo J, Anzueto A, Locantore N, Müllerova H, Tal-Singer R,
et al.; Evaluation of COPD Longitudinally to Identify Predictive Surro-
gate Endpoints (ECLIPSE) Investigators. Susceptibility to exarcerbation
in chronic obstructive pulmonary disease. N Engl J Med. 2010;
363(12):1128-38.
28. Ortiz JBS, Almagro P, Sauleda Roig J. Causas de mortalidad en la EPOC.
Arch Bronconeumol. 2009; 45(Supl 4):8-13.
29. Teixeira C, Cabral CR, Hass JS, Oliveira RP, Vargas MAO, Freitas APR, et al.
Exacerbação aguda da DPOC: mortalidade e estado funcional dois anos
após a alta da UTI. J Bras Pneumol. 2011; 37(3):334-40.
30. Csikesz NG, Gartman EJ. New developments in the assessment of COPD:
early diagnosis is key. Int J Chron Obstruct Pulmon Dis. 2014; 9:277-86.
31. Chetta A, Olivieri D. The COPD Assessment Test in the evaluation of chronic
obstructive pulmonary disease exacerbations. Expert Rev Resp Med. 2012;
6(4):373-5.
32.
Pooler A, Beech R. Examining the relationship between anxiety and depression
and exacerbations of COPD which result in hospital admission: a systematic
review. Int J Chron Obstruct Pulmon Dis. 2014; 9:315-30.
33.
Patel AR, Hurst JR, Wedzicha JA. The potencial value of biomarkers in
diagnosis and staging of COPD and exacerbations. Semin Respir Crit Care
Med. 2010; 31(3):267-75.
34.
Burgel PR, Paillasseur JL, Caillaud D, Tillie-Leblond I, Chanez P, Escamilla
R, et al. Longitudinal validation of clinical COPD phenotypes identified by
cluster analysis. Eur Respir J. 2010; 36:531-9.
35.
Hurst JR, Wedzicha JA. Management and prevention of chronic obstructive
pulmonary disease exacerbations: a state of the art review. BMC Med.
2009; 7:40.
36.
Müllerova H, Maselli DJ, Locantore N, Vestbo J, Hurst JR, Wedzicha JA, et
al. Hospitalized exacerbations of COPD: risk factors and outcomes in the
ECLIPSE cohort. Chest. 2015; 147(4):999-1007.
37.
Santibáñez M, Garrastazu R, Ruiz-Nuñez M, Helguera JM, Arenal S,
Bonnardeux C, et al. Predictors of hospitalized exacerbations and mortality
in chronic obstructive disease. PLoS One. 2016; 11(6):e0158727.