Resumen

CALDEROLI VARGAS, FE  y  CATEDRA DE NEUMOLOGIA. HOSPITAL DE CLINICAS. FACULTAD DE CIENCIAS MEDICAS. UNIVERSIDAD NACIONAL DE ASUNCION.. Valuation of diagnosis and treatment of patients with Chronic Obstructive Pulmonary Disease on discharge. An. Fac. Cienc. Méd. (Asunción) [online]. 2011, vol.44, n.1, pp.29-38. ISSN 1816-8949.

ABSTRACT Introduction: Chronic obstructive pulmonary disease (COPD) affects millions of people around the world; and globally it represents the fourth cause of death, although a preventable one. The annual cost of the disease and the money spent during the exacerbation can represent a catastrophic expense for the family and society; this makes the ambulatory treatment of the COPD of the outmost importance. Objectives: to evaluate the classification of the diagnosis, the adequacy of treatment, and the non-pharmacologic recommendations. As specific aim: to know smokers, main signs and symptoms, and to classify according to severity to those diagnosed by spirometry on discharge from hospital in patients with COPD. Material and methods: this study was observational, descriptive, and retrospective, with analytic component. Sixty two patients with COPD on discharge were included of a teaching hospital (years 2004 to 2008). Results: 46,8% of patients spirometry was done. The drugs used in decreasing frequency were short acting ß2 agonists 96,8%, anticholinergics 93,5%, long acting ß2 agonists 46,8%, long acting inhaled steroids 46,8%, oral steroids 25,8%, intravenous steroids 6,5%, short acting inhaled steroids 4,8%, and mucolitics 1,64%; non pharmacologic recommendations 24,2%. In relation to risk factors 87,1% were smokers or previous smokers. Between patients submitted to spirometry, the average age was 68,97 years, 79,3% were males, living the majority in the Central Region of the country; 89,7% were smokers or ex smokers with the following signs and symptoms: dyspnea 89,7%, cough 72,4%, sputum production 62,1%, wheezing 51,7%. Severity of illness according to grades were I (Mild) 7%, II (Moderate) 24.1%, III (Severe) 31% and IV (Very severe) 37,9%. Conclusions: in 47% of patients diagnosed as COPD spirometry was done. The more used drugs were: short acting ß2 agonists, short acting anticholinergics, followed by inhaled oral steroids and others. The non pharmacologic recommendations were rare. The more frequent signs and symptoms were dyspnea, cough, sputum production and wheezing. The majority was in category of severe or very severe. Keywords: pulmonary disease, chronic obstructive, therapeutics, classification.

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