Funcionalidade E Complicações Em Pacientes Gravemente Enfermos Reinternados No Hospital

Abstract

Conflito de interesses:Não Contribuição dos autores: LBD tabulação dos dados, delineamento do estudo, discussão dos achados, elaboração e redação do manuscrito, CCG orientação do projeto, discussão dos achados e redação do manuscrito, SML orientação do projeto, discussão dos achados e redação do manuscrito, NML discussão dos achados e redação do manuscrito, MAB orientação do projeto e discussão dos achados. Abstract Introduction:Patients with a prolonged Intensive Care Unit length of stay are subject to significant muscle and bone loss, especially those requiring extended sedation and ventilatory support. Objective: Evaluate the functionality, complications resulting from the hospitalization process in patients who were readmitted with the need of ventilatory support after being discharged from the Intensive Care Unit and describe possible interventions of Occupational Therapy. Patients and Methods: A prospective cohort study was carried out at Hospital de Base of São José do Rio Preto, state of São Paulo, between June and October 2014. We included adult patients readmitted to the hospital and that at some time during the current hospitalization needed mechanical ventilation in Intensive Care Units. A questionnaire was designed regarding Activities of Daily Living, mobility capacity, and complications resulting from the hospitalization process. Results: In the ward, 11,979 patients were admitted, of which 544 (4.5%) were readmitted after being discharged from the hospital. Of these, 200 patients needed mechanical ventilation at some time during hospitalization. They were included in the study. After discharge from the Intensive Care Unit, more than 80% of patients had partial or total functional dependence on Daily Life Activities. There was also a high prevalence of weight loss (51%), 13% developed pressure ulcers; 12% needed an enteral catheter for nutritional support, and 11% needed a tracheostomy. More than half of the patients had a prolonged hospital length of stay. Conclusion: Most patients who were readmitted and required mechanical ventilation had complications and important functional impairment after intensive care unit discharge. It is relevant to reflect the insertion of the multidisciplinary team in the hospital care, among them the occupational therapist, aiming to reduce secondary complications, new readmissions and the hospital costs.