Avaliação da associação de comorbidades com o COPD Assessment Test – CAT e a Modified Medical Research Council Dyspnea Scale – mMRC em pacientes com DPOC
Data
2016-10-31
Orientadores
Jardim, José Roberto de Brito 
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: Mais de 80% dos pacientes com DPOC apresentam, pelo menos, uma comorbidade. Entretanto, não é claro qual o impacto dessas comorbidades na qualidade de vida relacionada à saúde (QVRS) avaliada pelo COPD Assessment Test (CAT) e na dispneia avaliada pela Escala Modificada do Medical Research Council (mMRC) nesses pacientes. Objetivo: Determinar a influência das comorbidades no CAT e mMRC em pacientes com DPOC. Métodos: Estudo transversal multicêntrico realizado em cinco cidades brasileiras envolvendo pacientes com DPOC. O estudo analisou a QVRS avaliada pelo CAT, a dispneia pelo mMRC e as comorbidades desses pacientes. Resultados: Foram avaliados 926 pacientes com DPOC, sendo 56,4% do sexo masculino, idade 67,3+10,5 anos, volume expiratório forçado no primeiro segundo (VEF1) (%prev) 42,9+17,0, pontuação total do CAT 17,4+8,3 (média+DP) e mMRC 2 (2) (mediana; intervalo interquartil). Aproximadamente, 80% da amostra apresentaram, pelo menos, uma comorbidade, sendo a hipertensão arterial a comorbidade mais prevalente (55,1%). Pacientes com três ou mais comorbidades apresentaram significativamente pior pontuação do CAT (19,4 + 8,4) do que os grupos com uma ou duas comorbidades (16,9 + 8,2) ou nenhuma comorbidade (16,5 + 7,9). As variáveis mMRC, idade menos avançada, doença do refluxo gastro-esofágico (DRGE) e doença cardíaca explicaram 32% da maior pontuação do CAT (R2=0,32). A pontuação total do CAT, VEF1, baixo peso e doença cardíaca explicaram 40% do mMRC > 2 (R2=0,40). Conclusão: Comorbidades são prevalentes em pacientes com DPOC e possuem associação com os questionários CAT e mMRC.
Introduction: Over 80% of patients with COPD present at least one comorbidity. However, it is not yet clear what is the burden of these comorbidities upon the health related quality of life (HRQL) assessed by the COPD Assessment Test (CAT) and upon dyspnea assessed by the modified Medical Research Council Scale (mMRC). Objective: Determine the influence of comorbidities upon CAT and mMRC in patients with COPD. Methods: It is a multicenter transversal study carried out in five Brazilian cities involving patients with COPD. The study includes data on HRQL assessed by CAT, dyspnea assessed by mMRC and comorbidities presented by the patients. Results: 926 patients with COPD were evaluated, 56.4% male, age 67.3+10.5 years, forced expiratory volume in the first second (FEV1) (%pred) 42.,9+17.0, total score of CAT 17.4+8.3 and mMRC 2(2) (median; interquartile range). Approximately 80% of the sample presented at least one comorbidity, with arterial blood pressure being the most prevalent one (55.1%). Patients with three or more comorbidities showed significantly worse CAT score, 19.4 + 8.4 (mean+ SD), than the group with one or two comorbidities, 16.9 + 8.2, or none comorbidity, 16.5 + 7.9. The variables mMRC, age, gastroesophageal reflux disease (GERD) and cardiac disease explained 32% high scores of CAT (R2=0.321). The total score of CAT, FEV1, low weight and cardiac disease explained 40% of mMRC > 2 (R2=0.40). Conclusion: Comorbidities are prevalent in patients with COPD and negatively impact the scores of CAT and mMRC.
Introduction: Over 80% of patients with COPD present at least one comorbidity. However, it is not yet clear what is the burden of these comorbidities upon the health related quality of life (HRQL) assessed by the COPD Assessment Test (CAT) and upon dyspnea assessed by the modified Medical Research Council Scale (mMRC). Objective: Determine the influence of comorbidities upon CAT and mMRC in patients with COPD. Methods: It is a multicenter transversal study carried out in five Brazilian cities involving patients with COPD. The study includes data on HRQL assessed by CAT, dyspnea assessed by mMRC and comorbidities presented by the patients. Results: 926 patients with COPD were evaluated, 56.4% male, age 67.3+10.5 years, forced expiratory volume in the first second (FEV1) (%pred) 42.,9+17.0, total score of CAT 17.4+8.3 and mMRC 2(2) (median; interquartile range). Approximately 80% of the sample presented at least one comorbidity, with arterial blood pressure being the most prevalent one (55.1%). Patients with three or more comorbidities showed significantly worse CAT score, 19.4 + 8.4 (mean+ SD), than the group with one or two comorbidities, 16.9 + 8.2, or none comorbidity, 16.5 + 7.9. The variables mMRC, age, gastroesophageal reflux disease (GERD) and cardiac disease explained 32% high scores of CAT (R2=0.321). The total score of CAT, FEV1, low weight and cardiac disease explained 40% of mMRC > 2 (R2=0.40). Conclusion: Comorbidities are prevalent in patients with COPD and negatively impact the scores of CAT and mMRC.