RESUMEN
Introdução: Os pacientes com câncer podem apresentar múltiplos sintomas que se inter-relacionam, formando os chamados clusters ou agrupamentos de sintomas. Objetivo: Avaliar a relação entre um cluster de sintomas e a qualidade de saúde global de pacientes com câncer avançado. Método: Estudo analítico, transversal, com 146 pacientes. Foram utilizados instrumentos de caracterização sociodemográfica e de avaliação de qualidade de vida. Para análise dos dados, aplicaram-se os testes Kolmogorov-Smirnov, Mann-Whitney e Kruskal-Wallis. A coleta de dados foi realizada entre julho de 2019 e fevereiro de 2020 e utilizado o questionário 30-item European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30), versão 3. Resultados: A correlação de Spearmanmostrou-se positiva entre o escore final da escala de sintomas e o escore final da avaliação global da saúde (ρ=0,605; p<0,001). Além disso, observou-se que o incremento de 1 ponto na pergunta: "Precisou descansar?" associou-se com aumento de 5,87 pontos no escore da qualidade da saúde global (p<0,01); para a pergunta "Sentiu-se cansado/a?", 6,14 pontos (p<0,01); e "Teve falta de ar?", 5,08 pontos (p<0,01). Conclusão: Existe uma correlação positiva entre o cluster de sintomas composto por dor, fadiga, dispneia, náusea, vômito, insônia, inapetência, constipação, diarreia e a qualidade de saúde global de pacientes com câncer.
Introduction: Patients with cancer can present multiple symptoms that are interrelated, forming the so-called clusters or groups of symptoms. Objective: To evaluate the relationship between a cluster of symptoms and the global quality of life of patients with advanced cancer. Method:Analytical, cross-sectional study with 146 patients. Sociodemographic characterization and quality of life assessment instruments were used. For data analysis, the Kolmogorov-Smirnov, Mann-Whitney, and Kruskal-Wallis tests were applied. Data collection was carried out between July 2019 and February 2020 and the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30), version 3, was adopted. Results: Spearman's correlation was positive between the final score of the symptom scale and the final score of the global health assessment (ρ=0.605; p<0.001). In addition, it was observed that the increase of 1 point in the question "Did you need to rest?" was associated with an increase of 5.87 points in the global health quality score (p<0.01), for the question "Did you feel tired?", 6.14 points (p<0.01) and "Did you have shortness of breath?", 5.08 points (p<0.01). Conclusion: There is a positive correlation between the cluster of symptoms formed by pain, fatigue, dyspnea, nausea, vomiting, insomnia, lack of appetite, constipation, diarrhea and the overall health quality of patients with cancer.
Introducción: Los pacientes con cáncer pueden presentar múltiples síntomas que están interrelacionados, formando los llamados grupos o grupos de síntomas. Objetivo: Evaluar la relación entre uno grupo de síntomas y la calidad de vida general de los pacientes con cáncer avanzado. Método: Estudio analítico, transversal, con 146 pacientes. Se utilizaron instrumentos de caracterización sociodemográfica y de evaluación de la calidad de vida. Para el análisis de datos, se aplicaron las pruebas de Kolmogorov-Smirnov, Mann-Whitney y Kruskal-Wallis. La recolección de datos se llevó a cabo entre julio de 2019 y febrero de 2020 y se utilizó el cuestionario de calidad de vida básica de la Organización Europea para la Investigación y el Tratamiento del Cáncer (EORTC QLQ-C30), versión 3. Resultados: La correlación de Spearman fue positiva entre el puntaje final de la escala de síntomas y el puntaje final de la evaluación de salud global (ρ=0,605; p<0,001). Además, se observó que el aumento de 1 punto en la pregunta "¿Necesitabas descansar?" se asoció con un aumento de 5,87 puntos en el puntaje de calidad de salud global (p<0,01); para la pregunta "¿Se sintió cansado?", 6,14 puntos (p<0,01); y "¿Tuvo dificultad para respirar?", 5,08 puntos (p<0,01). Conclusión: Existe una correlación positiva entre el conjunto de síntomas compuestos por dolor, fatiga, disnea, náuseas, vómitos, insomnio, falta de apetito, estreñimiento, diarrea y la calidad de salud general de los pacientes con cáncer.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Calidad de Vida , Signos y Síntomas , Neoplasias , Perfil de Impacto de Enfermedad , Evaluación de SíntomasRESUMEN
Background: Cardiac magnetic resonance imaging provides detailed anatomical information on infarction. However, few studies have investigated the association of these data with mortality after acute myocardial infarction. Objective: To study the association between data regarding infarct size and anatomy, as obtained from cardiac magnetic resonance imaging after acute myocardial infarction, and long-term mortality. Methods: A total of 1959 reports of “infarct size” were identified in 7119 cardiac magnetic resonance imaging studies, of which 420 had clinical and laboratory confirmation of previous myocardial infarction. The variables studied were the classic risk factors – left ventricular ejection fraction, categorized ventricular function, and location of acute myocardial infarction. Infarct size and acute myocardial infarction extent and transmurality were analyzed alone and together, using the variable named “MET-AMI”. The statistical analysis was carried out using the elastic net regularization, with the Cox model and survival trees. Results: The mean age was 62.3 ± 12 years, and 77.3% were males. During the mean follow-up of 6.4 ± 2.9 years, there were 76 deaths (18.1%). Serum creatinine, diabetes mellitus and previous myocardial infarction were independently associated with mortality. Age was the main explanatory factor. The cardiac magnetic resonance imaging variables independently associated with mortality were transmurality of acute myocardial infarction (p = 0.047), ventricular dysfunction (p = 0.0005) and infarcted size (p = 0.0005); the latter was the main explanatory variable for ischemic heart disease death. The MET-AMI variable was the most strongly associated with risk of ischemic heart disease death (HR: 16.04; 95%CI: 2.64-97.5; p = 0.003). Conclusion: The anatomical data of infarction, obtained from cardiac magnetic resonance imaging after acute myocardial infarction, were independently ...
Fundamento: A ressonância magnética cardíaca fornece informações anatômicas detalhadas do infarto, porém poucos estudos investigaram a associação desses dados com mortalidade pós-infarto agudo do miocárdio. Objetivo: Verificar a associação entre os dados de anatomia e magnitude do infarto, obtidos da ressonância magnética cardíaca pós-infarto agudo do miocárdio, e mortalidade em longo prazo. Métodos: Foram identificados 1.959 laudos com “massa infartada” em 7.119 exames de ressonância magnética cardíaca, dos quais 420 possuíam documentação clínica e laboratorial de infarto agudo do miocárdio prévio. As variáveis estudadas foram os fatores de risco clássicos, fração de ejeção do ventrículo esquerdo, função ventricular categorizada e localização do infarto agudo do miocárdio. Massa infartada, extensão e transmuralidade do infarto agudo do miocárdio foram analisadas de maneira isolada e conjuntamente, pela variável denominada “MET-IAM”. A análise estatística foi feita pelo elastic net regularization, pelo modelo de Cox e por árvores de sobrevida. Resultados: A idade média foi 62,3 ± 12 anos, sendo 77,3% de homens. Durante o seguimento de 6,4 ± 2,9 anos, foram identificados 76 óbitos (18,1%). Creatinina sérica, diabetes melito e infarto agudo do miocárdio prévio demonstraram associação independente com mortalidade. A idade foi o principal fator explicativo. As variáveis da ressonância magnética cardíaca que se associaram de forma independente com a mortalidade foram: transmuralidade do infarto agudo do miocárdio (p = 0,047), disfunção ventricular (p = 0,0005) e massa infartada (p = 0,0005) − sendo essa última a principal variável explicativa para morte por doença isquêmica cardíaca. A variável MET-IAM exibiu a maior associação de risco para morte por doença isquêmica cardíaca (HR: 16,04; IC95%: 2,64-97,5; p = 0,003). Conclusão: Os dados anatômicos do infarto obtidos da ressonância magnética cardíaca pós-infarto ...
Asunto(s)
Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Imagen por Resonancia Magnética/métodos , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/mortalidad , Causas de Muerte , Determinación de Punto Final , Métodos Epidemiológicos , Infarto del Miocardio/fisiopatología , Índice de Severidad de la Enfermedad , Factores de Tiempo , Enfermedades Vasculares/mortalidad , Enfermedades Vasculares/fisiopatología , Disfunción Ventricular Izquierda/fisiopatología , Función Ventricular Izquierda/fisiologíaRESUMEN
BACKGROUND: Cardiac magnetic resonance imaging provides detailed anatomical information on infarction. However, few studies have investigated the association of these data with mortality after acute myocardial infarction. OBJECTIVE: To study the association between data regarding infarct size and anatomy, as obtained from cardiac magnetic resonance imaging after acute myocardial infarction, and long-term mortality. METHODS: A total of 1959 reports of "infarct size" were identified in 7119 cardiac magnetic resonance imaging studies, of which 420 had clinical and laboratory confirmation of previous myocardial infarction. The variables studied were the classic risk factors - left ventricular ejection fraction, categorized ventricular function, and location of acute myocardial infarction. Infarct size and acute myocardial infarction extent and transmurality were analyzed alone and together, using the variable named "MET-AMI". The statistical analysis was carried out using the elastic net regularization, with the Cox model and survival trees. RESULTS: The mean age was 62.3 ± 12 years, and 77.3% were males. During the mean follow-up of 6.4 ± 2.9 years, there were 76 deaths (18.1%). Serum creatinine, diabetes mellitus and previous myocardial infarction were independently associated with mortality. Age was the main explanatory factor. The cardiac magnetic resonance imaging variables independently associated with mortality were transmurality of acute myocardial infarction (p = 0.047), ventricular dysfunction (p = 0.0005) and infarcted size (p = 0.0005); the latter was the main explanatory variable for ischemic heart disease death. The MET-AMI variable was the most strongly associated with risk of ischemic heart disease death (HR: 16.04; 95%CI: 2.64-97.5; p = 0.003). CONCLUSION: The anatomical data of infarction, obtained from cardiac magnetic resonance imaging after acute myocardial infarction, were independently associated with long-term mortality, especially for ischemic heart disease death.