Autor(es):
Cukier, Alberto ; De Godoy, Irma [UNESP] ; Costa, Claudia Henrique da ; Rubin, Adalberto Sperb ; Gregorio, Marcelo Gervilla ; Neto, Aldo Agra de Albuquerque ; Lima, Marina Andrade ; Pereira, Monica Corso ; Tanni, Suzana Erico [UNESP] ; Athanazio, Rodrigo Abensur ; Bessa, Elizabeth Jauhar Cardoso ; Wehrmeister, Fernando Cesar ; Lourenco, Cristina Bassi ; Menezes, Ana Maria Baptista
Data: 2020
Identificador Persistente: http://hdl.handle.net/11449/199859
Origem: Oasisbr
Assunto(s): Brazil; Chronic obstructive; Disease progression; Pulmonary disease; Quality of life; Respiratory; Signs and symptoms; Brazil; Brazil; Chronic obstructive; Chronic obstructive; Disease progression; Disease progression; Pulmonary disease; Pulmonary disease; Quality of life; Quality of life; Respiratory; Respiratory; Signs and symptoms; Signs and symptoms
Descrição
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Objective: To analyze symptoms at different times of day in patients with COPD. Methods: This was a multicenter, cross-sectional observational study conducted at eight centers in Brazil. We evaluated morning, daytime, and nighttime symptoms in patients with stable COPD. Results: We included 593 patients under regular treatment, of whom 309 (52.1%) were male and 92 (15.5%) were active smokers. The mean age was 67.7 years, and the mean FEV1 was 49.4% of the predicted value. In comparison with the patients who had mild or moderate symptoms, the 183 (30.8%) with severe symptoms were less physically active (p = 0.002), had greater airflow limitation (p < 0.001), had more outpatient exacerbations (p = 0.002) and more inpatient exacerbations (p = 0.043), as well as scoring worse on specific instruments. The most common morning and nighttime symptoms were dyspnea (in 45.2% and 33.1%, respectively), cough (in 37.5% and 33.3%, respectively), and wheezing (in 24.4% and 27.0%, respectively). The intensity of daytime symptoms correlated strongly with that of morning symptoms (r = 0.65, p < 0.001) and that of nighttime symptoms (r = 0.60, p < 0.001), as well as with the COPD Assessment Test score (r = 0.62; p < 0.001), although it showed only a weak correlation with FEV1 (r = −0.205; p < 0.001). Conclusions: Dyspnea was more common in the morning than at night. Having morning or nighttime symptoms was associated with greater daytime symptom severity. Symptom intensity was strongly associated with poor quality of life and with the frequency of exacerbations, although it was weakly associated with airflow limitation.
Divisão de Pneumologia Instituto do Coração – InCor – Hospital das Clínicas Faculdade de Medicina Universidade de São Paulo
Disciplina de Pneumologia Faculdade de Medicina de Botucatu Universidade Estadual Paulista – UNESP
Disciplina de Pneumologia Universidade do Estado do Rio de Janeiro – UERJ
Universidade Federal de Ciências da Saúde de Porto Alegre Santa Casa de Misericórdia de Porto Alegre
Clínica Médica Netspiro
Departamento de Pneumologia Centro de Reabilitação Pulmonar Universidade Federal de São Paulo – UNIFESP
Hospital Dia do Pulmão
Disciplina de Pneumologia Departamento de Clínica Médica Faculdade de Ciências Médicas Universidade Estadual de Campinas
Universidade Federal de Pelotas
AstraZeneca do Brasil
Disciplina de Pneumologia Faculdade de Medicina de Botucatu Universidade Estadual Paulista – UNESP
