Conflito de interesses:Não Contribuição dos autores: JMM coleta, tabulação, delineamento do estudo e redação do manuscrito. EBS delineamento do estudo. RAPM delineamento do estudo e elaboração do manuscrito. ISF orientação do projeto, discussão dos achados, etapas de execução e elaboração do manuscrito, delineamento do estudo e elaboração do manuscrito. LMC orientação do projeto, delineamento do estudo e elaboração do manuscrito. ALW orientação do projeto, discussão dos achados, etapas de execução e elaboração do manuscrito, delineamento do estudo e elaboração do manuscrito. Contato para correspondência: Joice Marques Moura E-mail: joice_aww@hotmail. AbstractIntroduction: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Patients with sepsis (formerly called severe sepsis) should still be identified by the same organ dysfunction criteria (including lactate level greater than 2 mmol/L). Organ dysfunction may also be identified in the future using the quick Sepsis-Related Organ Failure Assessment (qSOFA). Currently, sepsis is one of the main causes of mortality in Intensive Care Units. In 2003, the Sepsis Surviving Campaign was created, elaborating a schedule of actions to reduce the incidence of sepsis, especially in intensive care units. Objective: To know the clinical characteristics and outcome of patients who developed sepsis during Intensive Care Units admission. Material and Methods: This is a retrospective, descriptive study using a quantitative approach performed at the Intensive Care Units. Data were obtained through an electronic medical record. The software Epi Info, version 7.2.1.0 was used to analyze data. Results:The largest number of patients hospitalized was male, aged from 51 to 70 years. The most common comorbidities were Systemic Hypertension, Diabetes Mellitus, alcoholism, smoking, and heart disease. The most analyzed post-sepsis outcome was discharge from Intensive Care Units, and the patients were considerably males. Conclusion: We conclude that the patients who most developed sepsis were men (62%), aged ranging from 51 to 70 years (36%). The main comorbidity was systemic hypertension (42%) and the most observed outcome was discharge from the Intensive Care Units (67%). consenso e novas definições de sepse foram publicadas, conhecidas como Sepsis 3, definida pela "presença de disfunção orgânica ameaçadora à vida secundária à resposta desregulada do organismo à infecção" (2) . Para avaliação do diagnóstico clínico de disfunção or gânica, atualmente são observados uma variação de dois ou mais pontos no escore Sequential Organ Failure Assessment (SOFA). Os critérios da síndrome da resposta inflamatória sistêmica (SRIS) não são mais usados para a definição. Os casos de sepse passam a ser considerados como doença grave, assim, não se usa mais a expressão "sepse grave". Choque séptico é definido como "um subgrupo dos pacientes com sepse que apresentam acentuadas anormalidades circulatórias, celulares e metabólicas e associadas com maio...
Background: The aim of this study was to estimate the incidence, main causes, and risk factors of iatrogenic disease occurring in a department of internal medicine. Methods: Over a 1-year period, physicians systematically filled out a 2-page questionnaire for all patients admitted to the ward. A database was created and the data were statistically analyzed. Patients undergoing immunosuppressive, chemo-, or radiation therapy were excluded. Missing data were completed by reviewing the patients' charts. The patients were then divided into two groups: those with and those without iatrogenic disease. The groups were compared using several parameters including gender, age, social features, days of hospitalization, associated illness, functional status, medical impression, prognosis, associated renal or liver function impairment, drugs taken daily, and outcome. In the group with iatrogenic disease, the type, severity, and predictability were also analyzed. Results: Of the 879 patients admitted to the ward, 445 completed questionnaires and were included in the study. A total of 102 patients (22.9%) developed 121 iatrogenic events. Forty-four patients (43.1%) were admitted for iatrogenic illness, 10 (9.8%) developed lifethreatening events, and in 3 (6.8%) it was the cause of death. Fifty-eight patients (56.8%) registered 77 episodes of iatrogenic disease during their hospital stay, 20 (19.6%) developed life-threatening events, and 9 (11.7%) died, 4 (5.2%) of an iatrogenic cause (nosocomial infections). Significant differences were found in 20 out of 26 parameters studied ( p b 0.005 for all cases; 95% confidence interval). Eighteen percent of all iatrogenic disease was severe, 61.9% predictable, 54.5% avoidable, and 59% drug-related, 80% of which was due to side effects or adverse reactions. Infection and metabolic and electrolyte disorders were the most frequent effects. Conclusions: It is possible to identify risk factors for iatrogenic events. Chronically ill elderly inpatients are the main target of iatrogenic events.
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