CONTEXTUALIZAÇÃO: A doença pulmonar obstrutiva crônica (DPOC) se caracteriza por ser uma afecção multissistêmica que leva a uma diminuição na tolerância ao exercício do paciente pneumopata. Atualmente, a Fisioterapia Respiratória dispõe de uma grande variedade de testes validados que tem como característica a sua simplicidade, praticidade e baixo custo. OBJETIVO: Descrever os testes de campo mais utilizados em pacientes com DPOC para avaliar a capacidade de exercício e a atividade física, assim como alguns testes que potencialmente poderiam ser adotados na avaliação clínica destes pacientes. CONCLUSÕES: Para poder justificar a qualidade do trabalho do profissional de Fisioterapia Respiratória, deve-se incorporar os testes utilizados e validados internacionalmente. Além disso, é importante escolher o teste mais adequado para medir a capacidade do exercício e, sobretudo, realizar um seguimento cuidadoso da evolução do paciente.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized as a multisystemic disease that reduces patient's tolerance to exercise. Nowadays, a great variety of validated tests are available for use in Respiratory Physical Therapy that are simple, practical and inexpensive. OBJECTIVE: To describe the tests most used in patients with COPD to evaluate their exercise capacity and physical activity, along with some tests that potentially could be adopted for clinical evaluations in such patients. CONCLUSIONS: To be able to justify the professional quality of the respiratory physical therapists' work, tests that have been used and validated internationally must be incorporated. Moreover, it is important to choose the most appropriate tests for measuring exercise capacity and, above all, to perform a careful follow-up of the patient.

The Internal Medicine service of the Hospital General de Vic (Barcelona) takes part in the mortality committee by revising and discussing in-hospital mortality. Background: to establish the characteristics of the deceased, death causes and to revise possible changes in the last six-years time or problems related to the exitus, to evaluate and improve hospitalized patients' assistance. Methodology: every case was revised following a specific register: demographical data, diagnosis and death cause, hospital death, documentation data, terminal or agonic situation when hospitalized, autopsies and death quality data. Exitus due to hospital problems were analyzed and classified in different groups. The statistical analysis was performed with measures of central tendency and of standard deviation. Results: During the revised six years, there were 819 exitus (5.1%). Global average death age was 79 ± 1.8 years: 52.5% were men and 47.4% were women; 22.8% died in less than forty-eight hours after hospitalization. The most frequent death causes were cerebrovascular accident (24%), chronic obstructive pulmonary disease (14.4%) and pneumonia (9.6%). There were a small number of autopsies (4.8%). Ratio of exitus due to hospital problems was stable during the six years (0.5%), in which nosocomial infection was the severest problem. Conclusions: The total percentage of exitus was 5.1%, higher than the common standards. Mortality causes coincide with other series. Ratio of exitus due to hospital problems was according to recommended objectives. The number of autopsies was very small. A correct completing and revision of the clinical recording is indispensable to spot a shortage in the hospitalized patients' assistance.

El Servicio de Medicina Interna del Hospital General de Vic (Barcelona) forma parte del comité de mortalidad revisando y discutiendo los fallecimientos hospitalarios. Fundamento y objetivo: establecer las características de los fallecidos, causas de muerte y revisar si existen cambios en los últimos 6 años o problemas en relación con el éxitus, para evaluar y mejorar la asistencia de los pacientes ingresados. Sujetos y métodos: se realizó revisión de cada caso a través de un registro específico con:datos demográficos, diagnóstico y causa de muerte, problemas hospitalarios, datos de documentación,situación terminal/agónica al ingreso, si se realizó autopsia y datos de calidad de muerte. Se analizan los éxitus secundarios a problemas hospitalarios (esphs). Para el análisis estadístico se utilizaron las medidas de centralización y dispersión estándar. Resultados: en los 6 años revisados hubieron 819 éxitus (5,1%), la edad media global fue de 79 ± 1,8 años.el 52,5% eran varones y el 47,4% mujeres, el 22,8% fallecieron en menos de 48 horas de ingreso.las causas más frecuentes de muerte fueron: el accidente vascular cerebral (24%),la enfermedad pulmonar obstructiva crónica (14,4%),la pneumonia (9,6%).el número de autopsias fue muy reducido (4,8%)los esphs se mantuvieron estables durante los 6 años, con una tasa del 0,5% siendo la infección nosocomial el problema más importante. Conclusiones: el porcentaje total de éxitus fue del 5,1%, superior a los estandards aconsejados. Las causas de mortalidad coinciden con otras series. La tasa de esphs se ajustó a los objetivos recomendados. El número de autopsias fue muy reducido. La correcta cumplimentación y revisión de la historia clínica es imprescindible para detectar déficits en la asistencia de los pacientes ingresados.