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Previous issue date: 2013-05-06 / Introduction: The detection of patients with Chronic Obstructive Pulmonary Disease (COPD) on the primary health care network can be an important tool for an early diagnosis and better conduct management of these patients. Studies realized in Latin America (MENEZES, 2006) show that the COPD underdiagnosis is one of the great limiters for the control of this illness. It was also observed in a study in Canada (Hill et al., 2010) that half of the cases sub-diagnosed were of hypertensive patients. Thus, the analysis of the pulmonary function in hypertensive patients could be a useful strategy for the diagnosis of patients with COPD. Objective: To estimate the prevalence of COPD and its sub-diagnosis on hypertensive patients registered on the HIPERDIA Program of an unit of primary health care in Goiânia. Methodology: The transversal analytical study performed on the Novo Horizonte CIAMS in Goiânia from January/2011 to May/2012, with patients from both sex, aged between 18 and 80 years old and hypertensive registered on the HIPERDIA Program. The patients were evaluated as for the pulmonary function (spirometry) and the respiratory symptoms (questionnaire). The criteria used for the diagnosis f COPD were in fixed relation of the VEF1/CVT<0,70 or by the relation VEF1/CVF below the inferior limit of normality. For the statistical analysis, it was appealed to the SPSS 17.0 program, with the execution of the square Qui test, T test and analysis of the logistical regression. The level of statistic significance assumed was of p < 0,05. The present study was approved by the Ethical Committee of Human Research from the Clinical Hospital of the Federal University of Goiás, register n° 159/2010. Results: 301 patients were evaluated. The prevalence of COPD was of 22,2% and the sub-diagnosis rate was of 82%. The group with normal spirometry (n=165) was compared to the group with COPD (n=67) as for the social demographic variables, pulmonary function, risk factors, the respiratory symptoms and the co morbidity. There were significant differences only in relation to the sex (p<0,001), age (p=0,005), CVF, VEF1/CVF (p<0,001), smoking (p<0,001) and wheezing (p=0,006). The group of patients with sub-diagnosed with COPD (n=55) and with previous diagnosis (n=12) were similar as for all the variables of epidemiological characterization, except for the respiratory symptoms (wheezing and dyspnea) and pulmonary function. Conclusion: The COPD patients’ profile is similar to the literature. The high prevalence of COPD found in the patients on the HIPERDIA Program with the majority of the sub-diagnosed, shows that the implantation of management strategies with patients with COPD in this National Program of Public Health is already existent in the majority of the Brazilian cities. / Introdução: A detecção de pacientes com Doença Pulmonar Obstrutiva Crônica (DPOC) na rede de atenção primária de saúde pode ser uma ferramenta importante para diagnóstico precoce e melhor manejo na conduta desses pacientes. Estudos realizados na América Latina (MENEZES, 2006) demonstraram que o subdiagnóstico de DPOC é um dos grandes limitadores para o controle dessa enfermidade. Também foi observado em um estudo no Canadá (HILL et al., 2010) que metade dos casos subdiagnosticados era de pacientes hipertensos. Sendo assim, a análise da função pulmonar em pacientes hipertensos poderá ser uma estratégia útil para o diagnóstico de pacientes com DPOC. Objetivo: Estimar a prevalência de DPOC e de seu subdiagnóstico em pacientes hipertensos cadastrados no Programa HIPERDIA de uma unidade de atenção primária à saúde em Goiânia. Metodologia: Estudo transversal analítico realizado no CIAMS do Novo Horizonte da cidade de Goiânia no período de janeiro/2011 a Maio/2012, com pacientes de ambos os sexos idade entre 18 e 80 anos, hipertensos inscritos no Programa HIPERDIA. Os pacientes foram avaliados quanto à função pulmonar (espirometria) e aos sintomas respiratórios (questionário). Os critérios usados para diagnóstico de DPOC foram pela relação fixa do VEF1/CVF<0,70 ou pela relação VEF1/CVF abaixo do limite inferior da normalidade. Para análise estatística, recorreu-se ao programa SPSS 17.0, com a realização de teste Qui quadrado, teste t student e análise de regressão logística. O nível de significância estatística adotado foi de p < 0,05. O presente estudo foi aprovado pelo Comitê de Ética em Pesquisa Humana do Hospital das Clínicas da Universidade Federal de Goiás, registro nº 159/2010. Resultados: Foram avaliados 301 pacientes. A prevalência de DPOC foi de 22,2% e a taxa de subdiagnóstico foi de 82%. Comparou-se o grupo com espirometria normal (n=165) com o grupo DPOC (n=67) quanto às variáveis sociodemográficas, a função pulmonar, os fatores de risco, os sintomas respiratórios e as comorbidades. Houve diferenças significantes apenas em relação a sexo (p<0,001), idade (p=0,005), CVF, VEF1 e VEF1/CVF (p<0,001), fumo (p<0,001) e sibilos (p=0,006). Os grupos de pacientes com DPOC subdiagnosticados (n=55) e com diagnóstico prévio (n=12) foram semelhantes quanto a todas as variáveis de caracterização epidemiológica, exceto quanto aos sintomas respiratórios (sibilo e dispneia) e função pulmonar. Conclusão: O perfil dos pacientes DPOC é semelhante ao da literatura. A alta prevalência de DPOC encontrada nos pacientes do Programa HIPERDIA com maioria de subdiagnosticados sinaliza para implantação de estratégias de manejo de pacientes com DPOC nesse Programa de Saúde Pública Nacional já existente na maioria dos municípios brasileiros.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.bc.ufg.br:tde/2983 |
| Date | 06 May 2013 |
| Creators | Pereira, Sheila Alves |
| Contributors | Rabahi, Marcelo Fouad |
| Publisher | Universidade Federal de Goiás, Programa de Pós-graduação em Ciências da Saúde (FM), UFG, Brasil, Faculdade de Medicina - FM (RG) |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da UFG, instname:Universidade Federal de Goiás, instacron:UFG |
| Rights | http://creativecommons.org/licenses/by-nc-nd/4.0/, info:eu-repo/semantics/openAccess |
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