<p>Hronična opstruktivna bolest pluća je jedna od najčešćih hroničnih bolesti pluća i važan uzrok morbiditeta i mortaliteta u svetu. Egzacerbacije predstavljaju značajan događaj u toku bolesti, jer imaju negativan uticaj na mortalitet, kvalitet života, opadanje plućne funkcije i povećanje troškova lečenja. Cilj rada je utvrditi nezavisne faktore rizika za egzacerbaciju i smrtni ishod tokom jednogodišnjeg praćenja obolelih od hronične opstruktivne bolesti pluća i kreiranje prediktivnog modela za neželjeni događaj. U ispitivanje je uključeno 200 pacijenata sa potvrđenom dijagnozom hronične opstruktivne bolesti pluća, koji su lečeni prema preporukama smernice Globalne inicijative za hroničnu opstruktivnu bolest pluća. Pacijenti su praćeni godinu dana, evaluirani na kontrolnim pregledima i beležen je broj egzacerbacija na osnovu vanrednih poseta i eventualni smrtni ishod. Statističkom obradom podataka utvrđeni su nezavisni prediktori egzacerbacije (starost > 65 godina, test procene hronične opstruktivne bolesti pluća > 9, modifikovana skala dispneje > 2, saturacija hemoglobina kiseonikom ≤ 93%) i smrtnog ishoda (starost >65 godina, potreba za primenom antiagregacione terapije, brzina maksimalnog ekspiratornog protoka na 25% vitalnog kapaciteta ≤ 1,16 l, modifikovana skala dispneje >2, puls > 89). Od navedenih nezavisnih faktora su kreirani modeli za predikciju neželjenih događaja. Unutrašnjom validacijom modela dokazana je dobra prediktivna vrednost oba matematička modela, bez statistički značajne razlike opserviranog i očekivanog procenta pojave egzacerbacije i smrtnog ishoda tokom praćenja pacijenata obolelih od HOBP.</p> / <p>Chronic obstructive pulmonary disease is one of the most common chronic lung diseases and is an important cause of morbidity and mortality in the world. Exacerbations are an important event in the course of the disease, as they have a negative impact on mortality, quality of life, lung function decline and increased costs of treatment. The aim of study is to identify risk factors for exacerbation or death during the one-year follow-up of patients with chronic obstructive pulmonary disease, and creation of predictive models for exacerbation and mortality during the follow-up period. The study included 200 patients with a confirmed diagnosis of chronic obstructive pulmonary disease who have had the therapy according to the Global initiative for chronic obstructive airway diseases guidelines. Patients were followed for one year, evaluated the number of exacerbations on the basis of emergency visits and eventual death. With statistical data processing there were identified independent predictors of exacerbations (age > 65 years, COPD Assessment Test > 9, modified Medical Research Council scale >2, oxygen saturation ≤ 93%) and death (age > 65 years, the need for application of antiplatelet therapy, the rate of maximum expiratory flow at 25% of vital capacity ≤ 1,16 l, modified Medical Research Council scale >2, heart rate > 89th). Of these independent factors was created a models for the prediction of adverse events during the one-year mark of COPD patients. Internal validation showed good predictive value of both models. No difference between the observed and the expected percentage of occurrence of exacerbations or death during the the follow-up period.</p>
| Identifer | oai:union.ndltd.org:uns.ac.rs/oai:CRISUNS:(BISIS)104740 |
| Date | 24 November 2017 |
| Creators | Tot Vereš Kristina |
| Contributors | Zvezdin Biljana, Kopitović Ivan, Stanić Jelena, Obradović Dušanka, Ilić Miroslav, Đurić Mirna |
| Publisher | Univerzitet u Novom Sadu, Medicinski fakultet u Novom Sadu, University of Novi Sad, Faculty of Medicine at Novi Sad |
| Source Sets | University of Novi Sad |
| Language | Serbian |
| Detected Language | Unknown |
| Type | PhD thesis |
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