Prognostic Criteria in Patient Admission in the Adult Intensive Care Unit: Subsidies for the Prevention of Complications From the Nursing Perspective

Abstract

The Intensive care is based on different technological resources, however, the use of prognostic criteria supported by scientific evidence can early identify parameters related to unfavorable outcomes. Objectives: To identify the impact of the prognostic criteria used in ICU in the admission of the patient that contribute to the clinical worsening. Methodology: Exploratory, descriptive, cross-sectional study with a quantitative approach, conducted in the Intensive Care Unit of the ''Hospital Universitário'' , linked to the ''Universidade de São Paulo'' . The sample consists of patients older than 18 years hospitalized between October 2021 and January 2022, regardless of the diagnosis. Results: The prognostic criterion used in the institution is the Simplified Acute Physiology Score III. As for the sociodemographic profile, male sex predominates, mean age of 63 years and mortality rate of 26.7%; in the clinical profile, 79% had comorbidities, with hypertension and diabetes mellitus predominant. In the first 24 hours of hospitalization, 46.8% underwent mechanical ventilation, 70.6% received sedatives and 57.3% needed vasoactive drugs. As for the clinical worsening profile, the highlight parameters were: age, vital signs, Braden scales, RASS and SAPS score 3, in addition to the results of laboratory tests. The study showed that the combination of altered urea values and TTPA increase the mortality rate, with a positive predictive value of 92.3% for death. Conclusion: Health professionals must be empathetic and skilled in recognizing and managing protocols for transgender children and adolescents. Public policies must guarantee specific conduct. This topic must be included in undergraduate and graduate courses in Health and Humanities. People must be guaranteed Human Rights, regardless of sexuality.