Perfil clínico-epidemiológico dos pacientes do ambulatório de metabolismo do cálcio atendidos no Centro de Especialidades Médicas do CESUPA

Abstract

Introduction: Bone Metabolic Disorders (BMD) represent a heterogeneous group of conditions that compromise the homeostasis of the skeletal system, with most of these cases presenting a chronic component that reinforces the need for patients to be treated on an outpatient basis, with specialized long-term follow-up as a cornerstone in health promotion. The proper management of these diseases have several obstacles, as it is influenced by factors such as the prolonged use of medication, age, and comorbidities, highlighting the need to identify all aspects that interfere with the health care of this specific population. Objective: To determine the clinical-epidemiological profile of patients attending the Calcium Metabolism Outpatient Clinic at the Center for Medical Specialties of CESUPA (CEMEC). Methodology: This is a cross-sectional descriptive analytical study carried out through the collection of data from medical records made available by the Center for Medical Specialties of CESUPA (CEMEC). Results: The sample of 245 medical records is predominantly composed of female patients (90.2%), aged over 60 years (68.2%), self-declared brown-skinned (66.1%), with systemic arterial hypertension (48.5%), and under follow-up for osteoporosis (78.4%). A significant association was found between the patients gender and the following pathologies: Osteoporosis (p<0.001), Low Bone Mass (p=0.007), Idiopathic Hypoparathyroidism (p=0.049), Post-surgical Hypoparathyroidism (p=0.015), and Osteogenesis Imperfecta (p<0.001). There was a predominance of follow-up time from 1 to 4 years (46.1%) and a frequency of 2 to 4 annual consultations (74.3%). Regarding adequate calcium consumption and the presence of early menopause, most of the sample did not have these characteristics (73.9% and 64.3%, respectively). Regarding the pattern of bone densitometry, there was a predominance of 1 to 2 exams registered (43.3%), and a positive association of this variable with follow-up time (p<0.001). The most observed T-Score results were <-3 and between -1 and -2.4 in the lumbar spine and femoral neck, respectively, with values <-3 significantly (p=0.002) associated with the occurrence of fractures. Total calcium and vitamin D values were mostly within the normal range (n=167; 68.2% and n=138; 56.3%, respectively). The most used drugs in the treatment of BMD were vitamin D (67.8%), calcium carbonate (41.6%), and bisphosphonates (59.6%). Conclusion: In light of the above, the individualization of care and the valorization of patients clinical history over standardized disease management protocols were evidenced. Such an approach was essential for the patients adherence to the initial therapeutic scheme, with a considerable clinical improvement in the underlying condition, based on evidence of predominance of laboratory tests within the normal range. Thus, the positive impact of the researched service on the maintenance of patients health is evident, and it is necessary to establish strategies to correct the identified shortcomings and further expand this positive scenario.