Camargo Lilia Azzi Collet da Rocha, Castellano Maria Vera Oliveira, Ferreira Fábio Checchia, Faria Flávio Vieira de, Carvas Nelson
MD, MSc in Health Sciences from Instituto de Assistência Médica ao Servidor Público Estadual (Iamspe). Assistant Physician of the Pulmonology Service, Hospital do Servidor Público Estadual (HSPE), São Paulo, SP, Brazil.
MD. Director of the Pulmonology Service, HSPE, São Paulo, SP, Brazil.
Rev Assoc Med Bras (1992). 2017 Jun;63(6):543-549. doi: 10.1590/1806-9282.63.06.543.
: Hospitalization due to chronic obstructive pulmonary disease exacerbation (eCOPD) may indicate worse prognosis. It is important to know the profile of hospitalized patients and their outcome of hospitalization to customize and optimize treatment.
: Evaluation of patients hospitalized for eCOPD, with ≥ 10 pack/years and ≥ 1 previous spirometry with airway obstruction over the course of one year at the pulmonology service of a general hospital, applying: COPD assessment test (CAT); mMRc and Visual Analogue Scale (VAS) for dyspnea; hospitalized anxiety and depression questionnaire (HAD); Divo's comorbidities and Cote index; spirometry; and laboratory tests including number of eosinophils, C-reactive protein (CRP), brain natriuretic protein (BNP). Patient progression, number of days of hospitalization and hospitalization outcomes were observed.
: There were 75 (12%) hospitalizations for eCOPD, with 27 readmissions, nine of which during a period ≤ 30 days after hospital discharge. The main outcomes were: number of days of hospitalization (17±16.5 [2-75]); hospital discharge (30 [62.5%] patients); discharge/rehospitalization (18 [37.5%] patients), eight of them more than once; death (7 [14.5%] patients), five during rehospitalization. We analyzed 48 patients in their first hospitalization. The sample comprised a heterogeneous group separated in three clusters according to age, FEV1, body mass index (BMI) and CAT. The clusters did not correlate with the main outcomes.
: Hospitalization for eCOPD is frequent. The number of readmissions was high and associated with death as an outcome. Patients hospitalized for eCOPD were a heterogeneous group separated in three clusters with different degrees of disease severity and no correlation with hospitalization outcomes.
因慢性阻塞性肺疾病急性加重（eCOPD）住院可能预示着更差的预后。了解住院患者的情况及其住院结局对于定制和优化治疗非常重要。
对在一家综合医院肺病科因eCOPD住院、吸烟史≥10包年且既往至少有1次肺功能检查显示气道阻塞的患者进行评估，应用：慢性阻塞性肺疾病评估测试（CAT）；改良医学研究委员会呼吸困难量表（mMRc）和视觉模拟量表（VAS）评估呼吸困难；住院焦虑和抑郁问卷（HAD）；迪沃共病情况和科特指数；肺功能检查；以及包括嗜酸性粒细胞计数、C反应蛋白（CRP）、脑钠肽（BNP）在内的实验室检查。观察患者病情进展、住院天数和住院结局。
共有75例（12%）因eCOPD住院，其中27例再次入院，9例在出院后≤30天内再次入院。主要结局包括：住院天数（17±16.5[2 - 75]天）；出院（30例[62.5%]患者）；出院/再次住院（18例[37.5%]患者），其中8例多次再次住院；死亡（7例[14.5%]患者），5例在再次住院期间死亡。我们分析了48例首次住院的患者。根据年龄、第1秒用力呼气容积（FEV1）、体重指数（BMI）和CAT，该样本分为三个不同的亚组。这些亚组与主要结局无相关性。
eCOPD住院情况较为常见。再次入院率较高且与死亡结局相关。因eCOPD住院的患者是一个异质性群体，分为三个不同程度疾病严重程度的亚组，且与住院结局无相关性。
