DETERMINACIÓN DEL ESTADO NUTRICIONAL EN PACIENTES CON ENFERMEDAD PULMONAR OBSTRUCTIVA CRÓNICA DEL PROGRAMA DE REHABILITACIÓN PULMONAR DEL HOSPITAL UNIVERSITARIO FUNDACIÓN SANTA FE DE BOGOTÁ DURANTE LOS AÑOS 2014-2015

Estefanía Zuluaga, Patricia Savino

Resumen


Introducción: La Organización Mundial de la Salud (OMS) estima que 65 millones de personas sufren de Enfermedad Pulmonar Obstructiva Crónica (EPOC) moderada o severa siendo una enfermedad crónica cuyos fenotipos se encuentran relacionados con el estado nutricional y generan efectos metabólicos, y también sistémica multiorgánica progresiva, presenciando cambios estructurales y funcionales adversos en tejidos coronarios y musculo-esqueléticos. En 1968 Filley describió dos fenotipos en la enfermedad pulmonar avanzada: el llamado soplador azul, hoy denominado bronquítico y el soplador rosado, conocido como enfisematoso. El enfisematoso es un paciente desnutrido tendiendo hacia la caquexia; mientras que el bronquítico en su mayoría se encuentra en sobrepeso u obesidad, y presenta comorbilidades metabólicas. Objetivo: determinar el estado nutricional en pacientes con EPOC mediante la antropometría y el fenotipo para establecer una terapia multimodal caracterizada por tratamiento médico, nutricional y un plan de ejercicio que mejore las condiciones generales del paciente. Metodología: Se realizó un estudio observacional transversal, con recolección de la información de manera retrospectiva, analizando los registros clínicos de los pacientes del programa de Rehabilitación Pulmonar en el Hospital Universitario de la Fundación Santa Fe de Bogotá con EPOC en los años 2014 a 2015, con edad mayor de 18 años, el total de pacientes es de 37, 62% (n=23) mujeres; 38% (n= 14) hombres. Resultados: Hubo una mayor prevalencia de EPOC en mujeres no fumadoras y exfumadoras. Los pacientes, independientes del género, se encontraban en un 43,24% (n=16) en sobrepeso u obesidad, con un WHtR mayor o igual a 0.6, implicando el aumento en el riesgo cardiovascular, diabetes y síndrome metabólico. Los pacientes que presentaron bajo peso fueron un 10,81%(n=4), diferente a lo reportado en la literatura. Conclusión: Es necesario realizar estudios con muestra de mayor tamaño, en quienes se establezca el fenotipo de EPOC, se determine la masa libre de grasa, y quienes idealmente pueden estar en una terapia multimodal. 

 

DETERMINATION OF NUTRITIONAL STATUS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE SEEN AT THE PULMONARY REHABILITATION PROGRAM OF THE HOSPITAL UNIVERSITARIO SANTA FE DE BOGOTÁ DURING YEARS 2014-2015

 

ABSTRACT

Introduction: The World Health Organization (WHO) estimates that 65 million people suffer from moderate or severe chronic obstructive pulmonary disease (COPD) being a chronic disease whose phenotypes are related to nutritional status and generate metabolic effects, as well as systemic progressive, presence of structural and functional changes in coronary and musculoskeletal tissues. In 1968 Filley described two phenotypes in advanced lung disease: the so-called blue blower, now called bronchial and the pink blower, known as emphysematous. The emphysematous is a malnourished patient tending toward cachexia; while the bronchitis is mostly found in overweight or obesity, and presents metabolic comorbidities. Objective: to determine the nutritional status in COPD patients through anthropometry and the phenotype to establish a multimodal therapy characterized by medical and nutritional treatment and an exercise plan that improves the general conditions of the patient. Methods: A cross-sectional observational study was performed with data collection retrospectively, analyzing the clinical records of patients from the Pulmonary Rehabilitation program at the University Hospital of the Santa Fe de Bogotá Foundation with COPD in the years 2014 to 2015, with age over 18 years, the total number of patients is 37, 62% (n = 23) women; 38% (n = 14) men. Results: There was a higher prevalence of COPD in non-smokers and ex-smokers. Patients, independent of gender, were 43.24% (n = 16) in overweight or obese, with a WHtR greater than or equal to 0.6, implying an increase in cardiovascular risk, diabetes and metabolic syndrome. The patients who presented low weight were 10.81% (n = 4), different from that reported in the literature. Conclusions: It is necessary to carry out studies with a larger sample, in which the phenotype of COPD is established, the fat-free mass is determined, and who ideally may be in a multimodal therapy.


Palabras clave


Epoc Enfisematoso, Bronquítico, Estado Nutricional, Índice WHTR, sobrepeso, Epoc Enisysematous, Bronchial, Nutritional Status, Index WHTR, Overweight

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