CLINICAL COMPLICATIONS OF EXACERBED COPD IN ELDERLY PEOPLE

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory condition that significantly compromises the quality of life of the elderly, especially when exacerbations occur. These exacerbations are associated with increased morbidity, hospitalization rates, and mortality risk, in addition to negatively impacting patient functionality. Factors such as respiratory infections, air pollution, and inadequate adherence to treatment contributed to the frequency and severity of these exacerbations. Clinically, elderly individuals with exacerbated COPD presented manifestations such as acute respiratory failure, increased hypercapnia, cardiovascular dysfunction, worsening of functional capacity, and cognitive impairment. Objective: To analyze the main clinical complications of exacerbated COPD in the elderly, identifying the pathophysiological impacts and therapeutic challenges, based on the scientific literature available in the last 10 years. Methodology: The research was conducted according to the PRISMA checklist guidelines, using the PubMed, SciELO, and Web of Science databases. Five descriptors were used in Portuguese and English: “Chronic Obstructive Pulmonary Disease”, “Exacerbation”, “Elderly”, “Clinical Complications” and “Hospitalization”. Inclusion criteria included original studies, systematic reviews and clinical trials that investigated clinical complications in elderly individuals with exacerbated COPD. Articles that did not present a specific age range, studies with inadequate methodology and publications in languages ​​other than English, Spanish and Portuguese were excluded. Results: The analysis revealed that COPD exacerbations in elderly individuals were strongly associated with increased in-hospital mortality rates, greater need for ventilatory support and cardiovascular complications, such as arrhythmias and pulmonary hypertension. Severe hypercapnia and respiratory acidosis were identified as negative prognostic factors. In addition, muscle deterioration and cognitive decline were recurrent consequences, compromising post-discharge recovery and increasing the vulnerability of these patients. Conclusion: Clinical complications of exacerbated COPD in elderly individuals involved respiratory, cardiovascular and neuromuscular aspects, reinforcing the need for individualized therapeutic strategies. The multidisciplinary approach and early management of exacerbations were essential to reduce the negative impacts and improve the survival of these patients.