Ishod plućne rehabilitacije u odnosu na nutritivni status bolesnika s kroničnom opstruktivnom plućnom bolesti

doctoral thesis

• Title (english): Pulmonary rehabilitation outcome in relation to the nutritional status of patients with chronic obstructive pulmonary disease
• Author: Davorka Muršić
• Mentor: Andrea Vukić Dugac (mentor)
• Committee member: Sanja Popović-Grle (predsjednik povjerenstva)
• Committee member: Željko Krznarić (član povjerenstva)
• Committee member: Đivo Ljubičić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2025-04-01, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Uvod: Kronična opstruktivna plućna bolest (KOPB) jedan je od vodećih uzroka smrti u svijetu i predstavlja velik javnozdravstveni problem. Liječenje je kompleksno te uz farmakološke, ključnu ulogu imaju i nefarmakološke mjere, prije svega plućna rehabilitacija. U dosadašnjim brojnim istraživanjima bolesnika s KOPB-om praćene su promjene u nutritivnom statusu bolesnika koje utječu na mortalitet, funkcionalni status bolesnika i kvalitetu života te pozitivan učinak plućne rehabilitacije.
Ispitanici i metode: U istraživanje je bio uključen 121 ispitanik s dijagnozom KOPB-a upućen na plućnu rehabilitaciju u Kliniku za plućne bolesti Jordanovac. Ispitanici su podijeljeni u tri skupine (A, B ili C) ovisno o nutritivnom statusu prema upitniku subjektivne općenite procjene (engl. Subjective Global Assessment - SGA). Svim ispitanicima je učinjena bioimpedancijska analiza i mjerene su vrijednosti albumina i prealbumina u krvi. Mjereni su ishodi plućne rehabilitacije, procjenom funkcijskog kapaciteta vježbanja, težine bolesti i kvalitete života, te su mjerene vrijednosti markera sistemske upale i lipidnog profila ispitanika.
Rezultati: Od svih ispitanika podjednak broj muškaraca i žena je bio u svakoj skupini (A, B i C). Prosječna dob uključenih ispitanika bila je 66,5 ± 7,5 godina uz najstariju populaciju u skupini SGA A. Temeljem bioimpedancijske analize i vrijednosti prealbumina nađene su statistički signifikantne razlike između skupina A, B i C (p<0,001). Usporedbom razlike u poboljšanju vrijednosti plućnih funkcija, 6-minutnog testa hoda te upitnika kvalitete života i težine bolesti između SGA skupine A, B i C, ishodi plućne rehabilitacije su bez statistički signifikantne razlike među skupinama. U laboratorijskim nalazima nije nađena signifikantna razlika u vrijednostima leukocita, CRP-a, fibrinogena i lipidnog profila između SGA skupina A,B i C.
Zaključak: Plućna rehabilitacija poboljšava kapacitet vježbanja i kvalitetu života bolesnika s KOPB-om, neovisno o njihovom nutritivnom statusu.

Abstract (english)

Introduction: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in the world and represents a major public health problem. The treatment of those patients is complex and, in addition to pharmacological treatment, non-pharmacological measures are very important, especially pulmonary rehabilitation.
Methods: The study included 121 subjects diagnosed with COPD who were referred for pulmonary rehabilitation at the Clinic for Respiratory disease Jordanovac. Subjects were divided into three groups (A, B and C) depending on nutritional status according to the Subjective Global Assessment (SGA) questionnaire. All subjects underwent bioimpedance analysis and measured albumin and prealbumin blood values. Pulmonary rehabilitation outcomes were measured by assessing the exercise capacity, disease severity and the quality of life. Values of the markers of systemic inflammation and the lipid profile were also measured.
Results: An equal number of men and women were in each group (A, B and C). The average age of the included subjects was 66.5 ± 7.5 years, with the oldest population in the SGA group A. Based on bioimpedance analysis and prealbumin values, statistically significant differences were found between groups A, B and C (p<0.001). By comparing the difference in the improvement of pulmonary function values, the 6-minute walk test and the quality of life questionnaire and disease severity between SGA groups A, B and C, the results of pulmonary rehabilitation were without statistically significant differences between the groups. In the laboratory findings, no significant difference was found in the values of leukocytes, CRP, fibrinogen and lipid profile between SGA groups A, B and C.
Conclusion: Pulmonary rehabilitation improves exercise capacity and quality of life in patients with COPD, regardless of their nutritional status.

• Keywords: Prealbumin; Test hodanja; Kvaliteta života; Fibrinogen; Tolerancija vježbanja; Nutritivni status; Uzrok smrti; Plućna bolest/kronična opstruktivna; Ishod liječenja; Poremećaji disanja; Leukociti; Upala; Lipidi
• Keywords (english): Prealbumin; Walk Test; Quality of Life; Fibrinogen; Exercise Tolerance; Nutritional Status; Cause of Death; Pulmonary Disease/Chronic Obstructive; Treatment Outcome; Respiration Disorders; Leukocytes; Inflammation; Lipids
• Language: croatian
• URN:NBN: urn:nbn:hr:105:018566
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 74 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2025-04-04 09:19:56