Perfil Epidemiológico E Seguimento Após Alta De Pacientes Internados Em Unidade De Terapia Intensiva

Albuquerque, Jonatas Mendes de; Silva, Renata Flávia Abreu da; Souza, Ruth Francisca Freitas de

doi:10.5380/ce.v22i3.50609

Cited by 9 publications

(14 citation statements)

References 17 publications

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“…e adjusted model described the association between older age and prevalence of mortality. Other studies identified similar relationship in ICU patients; however, the risk of death was linked to elderly patients [1,2,23,25,27]. Incidence of chronic diseases among younger adults has been observed in Brazil.…”

Section: Discussionmentioning

confidence: 69%

“…This study identified a 21% ICU mortality rate among patients in the hospital of Sergipe, northeastern Brazil. The mortality rate is considered high when compared to other national and international studies [ 1 , 2 , 23 – 25 ]. Age, admission from inpatient unit, sepsis, hydroelectrolyte imbalance, changes in glycemic index, tube feeding, mechanic ventilation, sedation with fentanyl, insulin use, and higher Charlson scores were associated with mortality in this study.…”

Section: Discussionmentioning

confidence: 97%

“…Demographic and clinical data were retrieved from medical records. The analysis divided patients into two groups according to hospitalization outcome as [ 1 ] death and [ 2 ] survival. Data were collected in two steps as [ 1 ] assessment with GCS or RASS and [ 2 ] assessment with CAM-ICU.…”

Section: Methodsmentioning

confidence: 99%

“…Patients with life-threatening conditions are treated in the intensive care unit (ICU). Treatment success and mortality rates in the ICU depend on the adequate utilization of human and technological sources [1]. ICU mortality has been associated with the length of hospitalization, patients' clinical condition, immobility [2], sedation, neurological disease, agitation, coma, intubation [3], mechanic ventilation, use of vasopressors drugs [4], glycemic index [5], sociodemographic characteristics, and delirium [6].…”

Section: Introductionmentioning

confidence: 99%

“…Selecting essential instruments to evaluate patients and determine standards of care is vital to ensure the quality of healthcare in the ICU. Several surveys can be employed to assess comorbidities and estimate mortality risk in this context [1,10]. For instance, the Charlson comorbidity index (CCI) identifies potential risk factors and contributes to a safe healthcare plan [11].…”

Section: Introductionmentioning

confidence: 99%

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Mortality Predictors and Associated Factors in Patients in the Intensive Care Unit: A Cross-Sectional Study

Pinheiro

Santana–Santos

Barreto

et al. 2020

Critical Care Research and Practice

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Background. Mortality in the intensive care unit (ICU) has been associated to an array of risk factors. Identification of risk factors potentially contribute to predict and reduce mortality rates in the ICU. The objectives of the study were to determine the prevalence and the factors associated with the mortality and to analyze the survival. Method. A cross-sectional study conducted in two clinical and surgical ICU in the state of Sergipe, northeastern Brazil. We enrolled 316 patients with at least 48 h of hospitalization, minimum age of 18 years old, sedated or weaned, with RASS ≥ −3, between July 2017 and April 2018. We categorized data in (1) age and gender, (2) clinical condition, and (3) prevalence of delirium. Data from enrolled patients were collected from enrollment until death or ICU discharge. Patients’ outcomes were categorized in (1) death and (2) nondeath (discharge). Results. Twenty-one percent of participants died. Age (53 ± 17 years vs. 45 ± 18 years, p<0.01), electrolyte disturbance (30.3% vs 18.1%, p=0.029), glycemic index (33.3% vs 18.2%, p=0.008), tube feeding (83.3% vs 67.1%, p=0.01), mechanical ventilation (50% vs 35.7%, p=0.035), sedation with fentanyl (24.2 vs 13.6, p=0.035), use of insulin (33.8% vs 21.7%, p=0.042), and higher Charlson score (2.61 vs 2.17, p=0.041) were significantly associated with death on the adjusted model. However, the regression model indicated that patients admitted from the emergency (HR = 0.40, p=0.006) and glycemic index alterations (HR = 1.68, p=0.047) were associated with mortality. There was no statistically significant difference (p=0.540) in survival between patients with and without delirium, based on the survival analysis and length of hospitalization. Conclusion. The prevalence of death was 21%, and age, electrolyte disturbance, glycemic index, tube feeding, mechanical ventilation, sedation with fentanyl, use of insulin, and higher Charlson score were associated with mortality.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Mortality Predictors and Associated Factors in Patients in the Intensive Care Unit: A Cross-Sectional Study

Pinheiro

Santana–Santos

Barreto

et al. 2020

Critical Care Research and Practice

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Avaliação psicológica de pacientes após a alta da unidade de terapia intensiva

Lopes¹,

Iepsen²,

Costa³

2020

Psico

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A maioria dos pacientes sobrevive ao episódio de doença crítica, contudo, muitos deles podem desenvolver alterações psicológicas após a alta desta unidade. Dada a natureza dos cuidados intensivos e as condições clínicas da maioria dos pacientes esta pesquisa tem como objetivo descrever os resultados da avaliação psicológica de pacientes três meses após a alta dos cuidados críticos. Foram avaliados 160 pacientes, no entanto, devido ao comprometimento neurológico apenas 137 conseguiram responder à avaliação psicológica. Os instrumentos utilizados foram: Planilha para coleta de dados do prontuário, instrumento de avaliação de memórias de UTI, Impact of Event Scale-Revised (IES-R) e Escala Hospitalar de Ansiedade e Depressão (HADS). Os resultados revelaram que a identificação precoce das complicações inerentes ao tratamento crítico poderá trazer benefícios para a prevenção de alterações emocionais/físicas crônicas subsequentes.

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Epidemiological profile and risk factors associated with death in patients receiving invasive mechanical ventilation in an adult intensive care unit from Brazil: a retrospective study

2023

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IntroductionUnderstanding the epidemiological profile and risk factors associated with invasive mechanical ventilation (IMV) is essential to manage the patients better and to improve health services. Therefore, our objective was to describe the epidemiological profile of adult patients in intensive care that required IMV in-hospital treatment. Also, to evaluate the risks associated with death and the influence of positive end-expiratory pressure (PEEP) and arterial oxygen pressure (PaO2) at admission in the clinical outcome.MethodsWe conducted an epidemiological study analyzing medical records of inpatients who received IMV from January 2016 to December 2019 prior to the Coronavirus Disease (COVID)-19 pandemic in Brazil. We considered the following characteristics in the statistical analysis: demographic data, diagnostic hypothesis, hospitalization data, and PEEP and PaO2 during IMV. We associated the patients’ features with the risk of death using a multivariate binary logistic regression analysis. We adopted an alpha error of 0.05.ResultsWe analyzed 1,443 medical records; out of those, 570 (39.5%) recorded the patients’ deaths. The binary logistic regression was significant in predicting the patients’ risk of death [X2(9) = 288.335; p < 0.001]. Among predictors, the most significant in relation to death risk were: age [elderly ≥65 years old; OR = 2.226 (95%CI = 1.728–2.867)]; male sex (OR = 0.754; 95%CI = 0.593–0.959); sepsis diagnosis (OR = 1.961; 95%CI = 1.481–2.595); need for elective surgery (OR = 0.469; 95%CI = 0.362–0.608); the presence of cerebrovascular accident (OR = 2.304; 95%CI = 1.502–3.534); time of hospital care (OR = 0.946; 95%CI = 0.935–0.956); hypoxemia at admission (OR = 1.635; 95%CI = 1.024–2.611), and PEEP >8 cmH2O at admission (OR = 2.153; 95%CI = 1.426–3.250).ConclusionThe death rate of the studied intensive care unit was equivalent to that of other similar units. Regarding risk predictors, several demographic and clinical characteristics were associated with enhanced mortality in intensive care unit patients under mechanical ventilation, such as diabetes mellitus, systemic arterial hypertension, and older age. The PEEP >8 cmH2O at admission was also associated with increased mortality since this value is a marker of initially severe hypoxia.

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Perfil Epidemiológico E Seguimento Após Alta De Pacientes Internados Em Unidade De Terapia Intensiva

Cited by 9 publications

References 17 publications

Mortality Predictors and Associated Factors in Patients in the Intensive Care Unit: A Cross-Sectional Study

Mortality Predictors and Associated Factors in Patients in the Intensive Care Unit: A Cross-Sectional Study

Avaliação psicológica de pacientes após a alta da unidade de terapia intensiva

Epidemiological profile and risk factors associated with death in patients receiving invasive mechanical ventilation in an adult intensive care unit from Brazil: a retrospective study

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