RESUMO
INTRODUCTION: Emerging evidence suggests that gender differences exist in the prevalence, susceptibility, severity and response to the treatment of COPD. This article compares the characteristics of acute exacerbation in male and female patients hospitalized for acute chronic obstructive pulomnary disease (COPD) exacerbation. METHODS: This observational study collected data from 1,824 patients admitted to the pneumology department in 68 general hospitals between October 2006 and June 2007. RESULTS: The 423 (23.2%) women were younger than the men (69.1 versus 70.6 years; p=0.016) and more frequently non-smokers (14.4% versus 4.2%; p<0.0001). Before the acute exacerbation, they more frequently reported asthma (18% versus 11.6%; p=0.0006) or bronchiectasis (10.4% versus 5.9%; p=0.002). They also more often presented consciousness disorders (6.4% versus 3.9%; p=0.033) and desaturation (SpO2<90%: 50.4% versus 42%; p=0.002) during acute exacerbation and their hypercapnia was more severe (50.7 versus 46.5mmHg; p<0.0001). During hospitalization, they were more frequently ventilated (23.9 versus 17.1%; p=0.002). There was no difference in the mortality between the sexes (1.4% versus 2.8%; p=0.11). Age and smoking behavior were closely related in the female patients: the smokers were younger (62.5 years) than the ex-smokers (73.7 years) or non-smokers (78.1 years). Of the six women who died during hospitalization, two were smokers and four ex-smokers. In addition, four were over 80 years old. CONCLUSION: The women hospitalized for acute COPD exacerbation differed from the men with respect to risk factors, steady-state COPD severity and exacerbation severity.
Assuntos
Doença Pulmonar Obstrutiva Crônica , Doença Aguda , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Fatores de Risco , Índice de Gravidade de Doença , Fatores SexuaisRESUMO
INTRODUCTION: A cohort was formed to explore the evolution of COPD patients treated in general hospitals for acute exacerbations (AE). The present article describes and compares patient characteristics according to whether COPD was diagnosed before the AE or not. METHODS: Data were analyzed for 1,824 patients admitted between October 2006 and June 2007 to 68 departments of respiratory medicine. RESULTS: Population characteristics were: male, 77%; mean age, 70.3+/-11.3 years; current smokers, 33%; baseline grade 3-4 dyspnoea, 47%; FEV1Assuntos
Progressão da Doença
, Hospitalização/estatística & dados numéricos
, Doença Pulmonar Obstrutiva Crônica/diagnóstico
, Doença Aguda
, Fatores Etários
, Idoso
, Idoso de 80 Anos ou mais
, Estudos de Coortes
, Estudos Transversais
, Dispneia/epidemiologia
, Dispneia/etiologia
, Feminino
, Volume Expiratório Forçado
, França
, Humanos
, Masculino
, Pessoa de Meia-Idade
, Doença Pulmonar Obstrutiva Crônica/epidemiologia
, Fatores Sexuais
, Fumar/efeitos adversos
, Fumar/epidemiologia
RESUMO
INTRODUCTION: COPD is a disease whose gravity is underestimated by doctors and patients. The development of acute exacerbations (AE) accelerates the progression of the disease and leads to increased financial costs, notably on account of hospitalisation. MATERIALS AND METHODS: An observational prospective study will be undertaken based on a cohort of consecutive patients hospitalised in departments of respiratory medicine in general hospitals. The main objective is to study the factors predictive of mortality at 3 years after one admission for AE. The secondary objectives are to describe the characteristics of the AE on arrival and 3 months after discharge from hospital. A register will be set up and a questionnaire will be completed for each patient, consisting of items concerning COPD, the AE and the condition of the patient and his treatments 3 months after discharge. The level of mortality at 3 years and the predictive factors will be calculated from the data in the register. EXPECTED RESULTS: Identification the characteristics of the AE and determination of a predictive score for mortality should allow optimisation of the management of patients suffering from COPD.