Co-morbidities in patients with gold stage 4 chronic obstructive pulmonary disease [Comorbilidades em doentes com doença pulmonar obstrutiva crónica estádio IV]

Chronic obstructive pulmonary disease (copd) is associated with several co-morbidities,however their prevalence varies from one study to another. aim: to determine the prevalence of several co-morbidities in patients with copd severity score gold 4 (the global initiative for chronic obstructive lung disease,2010) followed in ambulatory care,in a university hospital. methods: a questionnaire was designed and carried out in order to characterize copd and its co-morbidities. clinical files were consulted in order to complete the data. results: 89 patients (87% male) with a mean age of 68 years old,of which 79% were ex-smokers,were included. the average value of fev1 (forced expiratory volume in one second) was 38% of the expected values and all the patients presented chronic respiratory failure. thirty-five patients (39%) were frequent exacerbators.thirty-seven patients (42%) had been hospitalized at least once due to exacerbation of their respiratory disease in the previous year,and 66 patients (74%) hospitalized in the previous five years.most of the patients (97%) presented at least one comorbidity,with an average of 4 co-morbidities per patient and an average charlson index of 2.the most frequent co-morbidities were cardiovascular diseases (69%),osteoarticular pathology (51%),erectile dysfunction (48%),sleep apnoea syndrome (43%) dyslipidaemia (35%),cataracts (31%),gastroesophageal reflux (29%) and diabetes (20%).frequent exacerbators presented an increased risk of having two or more co-morbidities (odds ratio of 5),as well as a higher prevalence of gastroesophageal reflux (p. = 0.0006) and more hospitalizations in the last year and in the previous 5 years (p < 0.001). conclusion: this study confirmed the high prevalence and the association of co-morbidities in patients with copd severity score gold 4,thus justifying the need for a comprehensive and integrating therapeutic approach. © 2012 sociedade portuguesa de pneumologia.