Dispnéia aguda e morte súbita em paciente com má percepção da intensidade da obstrução brônquica

Souza‐Machado, Adelmir; Alcoforado, Gustavo Henrique de Medeiros; Cruz, Álvaro A.

doi:10.1590/s0102-35862001000600008

Cited by 6 publications

(8 citation statements)

References 18 publications

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“…These patients, who do not recognize or do not perceive the severity of symptoms are the ones who present greater risks of exacerbations (8) and death by asthma. (9,10) In this sense, it is important to offer physicians and patients (11,12) simple, rapid and lowcost instruments to precisely assess asthma control, both in outpatient clinics as in primary health care, (13) allowing treatment adjustments whenever necessary.…”

Section: Introductionmentioning

confidence: 99%

Avaliação do questionário de controle da asma validado para uso no Brasil

Leite¹,

Ponte²,

Petroni

et al. 2008

J. bras. pneumol.

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Objective: To evaluate whether the Portuguese version of the Asthma Control Questionnaire (ACQ) is a valid instrument to measure asthma control in adult outpatients in Brazil. Methods: We selected 278 outpatients diagnosed with asthma. All of the patients completed the questionnaire, underwent spirometry and were clinically evaluated by a physician in order to characterize the control of the disease in the first visit. The questionnaire was evaluated in three versions, with 5, 6 and 7 questions, respectively, and scores of 0.75 and 1.50 were used as cut-off points. Results: Of the 278 patients, 77 (27.7%) had intermittent asthma, 39 (14.0%) had mild persistent asthma, 40 (14.4%) had moderate persistent asthma and 122 (43.9%) had severe persistent asthma. The sensitivity of ACQ to identify uncontrolled asthma ranged from 77% to 99%, and the specificity ranged from 36% to 84%. The positive predictive value ranged from 73% to 90%, and the negative predictive value ranged from 67% to 95%. The positive likelihood ratio ranged from 1.55 to 4.81, and the negative likelihood ratio ranged from 0.03 to 0.27. In the 5-and 6-question versions of the ACQ, the intraclass correlation coefficient was 0.92. These two versions were both responsive to clinical changes in the patients. Conclusions: All three versions of the ACQ satisfactorily discriminated between patients with uncontrolled asthma and those with controlled asthma. The 5-and 6-question versions also presented good reliability and responsiveness. Therefore, the ACQ is a valid tool for evaluating asthma control in adult outpatients in Brazil.Keywords: Asthma; Therapeutics; Diagnosis; Questionnaires; Reproducibility of results. ResumoObjetivo: Avaliar se a versão em língua portuguesa do Asthma Control Questionnaire (ACQ, Questionário de Controle da Asma) é um instrumento válido para medir o controle da asma em pacientes adultos ambulatoriais no Brasil. Métodos: Foram avaliados 278 pacientes ambulatoriais com diagnóstico de asma. Todos os pacientes, durante a primeira visita, responderam ao questionário, foram submetidos à espirometria e avaliados clinicamente por um médico para a caracterização do controle da doença. Foram analisadas as versões do questionário com 5, 6 e 7 questões, utilizando dois escores distintos (0,75 e 1,50) como pontos de corte. Resultados: Dos 278 pacientes, 77 (27,7%) tinham asma intermitente, 39 (14,0%) asma persistente leve, 40 (14,4%) asma persistente moderada e 122 (43,9%) asma persistente grave. A sensibilidade do questionário para identificar asma não-controlada variou de 77% a 99% e a especificidade variou de 36% a 84%. O valor preditivo positivo variou de 73% a 90%, e o valor preditivo negativo variou de 67% a 95%. A razão de verossimilhança positiva variou de 1,55 a 4,81, e a razão de verossimilhança negativa variou de 0,03 a 0,27. Nas versões do ACQ com 5 e 6 questões, o coeficiente de correlação intraclasse foi de 0,92, e estas versões foram responsivas a mudanças no quadro clínico dos pacientes. Conclusões: O ACQ, nas suas t...

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Section: Introductionmentioning

confidence: 99%

Avaliação do questionário de controle da asma validado para uso no Brasil

Leite¹,

Ponte²,

Petroni

et al. 2008

J. bras. pneumol.

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“…treatment protocols. (14,(21)(22)(23)(24)(25)(26)(27) In addition, the judicious evaluation of patient histories, the risks associated with the disease and the determination of pulmonary function parameters are frequently ignored. We highlight the fact that six patients in this series reported no hospitalizations; two of these reported no visits to emergency rooms until the time of death.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with asthma whose perception is poor are at risk of underestimating their disease and receiving insufficient treatment. (21)(22)(23)(24)(25) It has been reported that asthma-related deaths are more common on weekends and at night; curiously, deaths from acute myocardial infarction are more common on Mondays and in the morning. (13,14) In this series of cases, deaths predominantly occurred on Mondays from 12 am to 12 pm, which suggests that there was a delay in seeking medical attention.…”

Section: Discussionmentioning

confidence: 99%

Causas de óbitos entre asmáticos graves admitidos no Programa de Controle da Asma e da Rinite Alérgica na Bahia

et al. 2007

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Objective: To report demographic and clinical characteristics of patients with asthma who evolved to death, as well as to describe the conditions related to this outcome in a subgroup of patients admitted to the Program for the Control of Asthma and Allergic Rhinitis in Bahia (ProAR). Methods: A descriptive, retrospective, observational study. Data from clinical charts and death certificates of 16 patients of 930 subjects with severe asthma monitored at the ProAR Central Reference Center from December 2003 to June 2006 were reviewed. Results: Of the 930 patients participating in the program, 16 (1.72%) died. Of these, there were 10 males and 6 females, ranging in age from 39 to 74 years (median, 55 years); 12 (75%) of the patients were black. Time since diagnosis ranged from 1 to 68 years (median, 30 years). In 43.8 and 53.8%, respectively, there was a personal or family history of atopy. Ex-smokers (<10 pack-years) accounted for 37.5% of the cases. Causes of death listed on the death certificates were as follows: asthma or asthma exacerbations in 8 (50%); respiratory failure in 3 (18.75%); acute heart infarction in 2 (12.5%); hepatitis in 1 (6.25%); hypovolemic shock in 1 (6.25%); and cardiorespiratory arrest in 1 (6.25%). Of the 16 deaths, 13 (81.25%) occurred inside hospitals. Conclusion: Asphyxia and cardiovascular diseases were the most common attributed causes of mortality in this subgroup of patients with severe asthma. Hospital-based mortality, male gender, advanced age, long-term disease and fixed airflow obstruction were the aspects most frequently observed in the cases studied.

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“…Afeta cerca de 10% da população, sendo considerada um sério problema de saúde pública (4) . No Brasil, em 1996, a asma foi a quarta causa de internação nos hospitais do Sistema Único de Saúde e é responsável por uma média de 2000 óbitos/ano, aproximadamente 70% destes, durante hospitalizações dos pacientes (5) .…”

Section: Introductionunclassified

“…Estímulos aferentes de receptores vagais, mecanorreceptores localizados na parede torácica e quimiorreceptores são responsáveis pela retroalimentação de informações para o tronco cerebral. O trabalho respiratório e as pressões intrabrônquicas e transtorácicas alteradas parecem contribuir para o desconforto da dispnéia (4) . A avaliação do paciente com dispnéia, que chega ao serviço de emergência ou ao serviço de pronto-atendimento, usualmente inclui freqüência respiratória, oximetria de pulso (para verificar a saturação periférica de oxigênio, SpO 2 ), cor da pele, ausculta respiratória, habilidade de falar e o que desencadeou o episódio.…”

Section: Introductionunclassified

Avaliação do uso da Escala Modificada de Borg na crise asmática

Cavallazzi

Cavalcante

et al. 2005

Acta paul. enferm.

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INTRODUÇÃOEm pacientes com doenças respiratórias, o sintoma de dispnéia é um dos mais comuns e pode demonstrar uma complicação significativa. A sensação de dispnéia é uma experiência sensorial que é percebida, interpretada e medida pelo indivíduo (1) . A dificuldade ou desconforto respiratório é provavelmente o fator isolado mais importante, na limitação da capacidade do indivíduo nas funções básicas do dia-a-dia, fazendo com que este procure logo o serviço de saúde (2)

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Dispnéia aguda e morte súbita em paciente com má percepção da intensidade da obstrução brônquica

Cited by 6 publications

References 18 publications

Avaliação do questionário de controle da asma validado para uso no Brasil

Avaliação do questionário de controle da asma validado para uso no Brasil

Causas de óbitos entre asmáticos graves admitidos no Programa de Controle da Asma e da Rinite Alérgica na Bahia

Avaliação do uso da Escala Modificada de Borg na crise asmática

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