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Revista médica de Chile

versão impressa ISSN 0034-9887

Resumo

SALDIAS, Fernando; GASSMANN, Javiera; CANELO, Alejandro  e  DIAZ, Orlando. Variables clínicas y funcionales asociadas al riesgo de muerte en el seguimiento a largo plazo en pacientes con enfermedad pulmonar obstructiva crónica. Rev. méd. Chile [online]. 2018, vol.146, n.4, pp.422-432. ISSN 0034-9887.  http://dx.doi.org/10.4067/s0034-98872018000400422.

Background:

Identifying risk factors for long-term mortality in patients with chronic obstructive pulmonary disease (COPD) could improve their clinical management.

Aim:

To examine the clinical variables associated to long-term mortality in a cohort of COPD patients.

Patients and Methods:

A clinical and respiratory functional assessment, chest computed tomography and clinical follow up for five years was carried out in 202 COPD patients aged 66 ± 9 years (59% males), active or former smokers of 10 or more pack-years.

Results:

Thirty four percent of patients were active smokers, consuming 46 ± 23 packs/year, 86% had comorbidities, especially chronic cardiovascular and metabolic diseases. Forty-six patients died in the five years follow-up (5-year mortality was therefore 22.8%). In the univariate analysis, the main risk factors associated to long-term mortality were an older age, male sex, dyspnea severity, severe exacerbation risk, chronic respiratory failure, magnitude of lung emphysema, airflow obstruction and lung hyperinflation, reduction of thigh muscle cross-sectional area and physical activity limitation. In the multivariate analysis, the three independent risk factors for long-term mortality were dyspnea severity, chronic hypoxemia and exercise limitation measured with the six minutes’ walk test.

Conclusions:

Systematic clinical assessment allowed to identify the main risk factors associated with long-term mortality in patients with COPD, which could be used in planning preventive and management programs aimed at the high-risk population.

Palavras-chave : Pulmonary Disease; Chronic Obstructive; Mortality; Prognosis; Risk Factors.

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