Determinantes da fragilidade em indivíduos com DPOC dependentes de oxigênio na atenção primária

Abstract

Introduction: Frailty has been described as a multidimensional syndrome, involving biological, physical, cognitive, social, economic and environmental factors. It can be the result of a diversity of diseases and health conditions. It is an important prognostic and mortality marker. The Tilburg Frailty Indicator (TFI) is an instrument capable of broadly assessing frailty and presents good predictive validity for quality of life and adverse effects. In patients with Chronic Obstructive Pulmonary Disease (COPD), frailty is associated with mortality, however little is known about this condition in patients dependent on Long-Term Oxygen Therapy (LTOT). Objectives: To verify the prevalence of fragility in elderly people with COPD dependent on LTOT, who are attended in primary care, and to identify possible associated clinical and/or socio-demographic factors. Materials and Methods: A cross-sectional and descriptive study was carried out between July and September of 2018, with elderly people with COPD, dependent on LTOT and assisted in primary care units. Frailty was identified through a multidimensional instrument, the TFI. All subjects performed a spirometry, manovacuometry and capnography, in addition to a six-minute walk test and hand grip strength test. Results: A total of 22 elderly people were included in the analysis. Prevalence of frailty was identified in 91% of the sample. Frail patients presented a significant difference in the distance walked on the 6MWT (p <0.05) and hand grip strength test (p <0.05). The variables age, polypharmacy, multicomorbidities and dyspnea presented high risk for developing fragility. Conclusion: We found a high prevalence of frailty in patients with COPD assisted in primary care. Faced with this, there is an increased risk of morbidity, hospitalization and death. The early identification of frailty allows more effective interventions in the attempt to interrupt this process which leads directly to adverse health effects.