The incidence from March 2003 to March 2005 of PPCs in patients who had undergone craniotomy was 25% and death occurred in 10%. Some risk factors for PPCs may be predicted such as the type of surgery performed, prolonged mechanical ventilation, a longer time in the ICU, a decreased level of consciousness, duration of surgery, and previous chronic lung disease.

The f/V (t) ratio does not predict extubation failure in patients who have undergone elective craniotomy. Patients who fail extubation present higher incidence of pneumonia, tracheostomy and higher mortality rate.

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48 h) until discharge from the hospital or death. The occurrence of PPC, incidence of death, the need for reoperation and tracheostomy, and the length of hospitalization were assessed during the postoperative period. Twenty-six patients (8.2%) experienced extubation failure and 30 (9.5%) needed prolonged MV after surgery. Multivariate analysis showed that extubation failure was significant for the occurrence of death (OR = 8.05 [1.88; 34.36]), PPC (OR = 11.18 [2.27; 55.02]) and tracheostomy (OR = 7.8 [1.12; 55.07]). Prolonged MV was significant only for the occurrence of PPC (OR = 4.87 [1.3; 18.18]). Elective intracranial surgery patients who experienced extubation failure or required prolonged MV had a higher incidence of PPC, reoperation and tracheostomy and required a longer period of time in the ICU. Level of consciousness and extubation failure were associated with death and PPC. Patients who required prolonged MV had a higher incidence of extubation failure.]]>

Lower level of consciousness (GCS 8T-10T) and female sex were considered risk factors for extubation failure in subjects submitted to elective intracranial surgery.

CONTEXT AND ObjECTivE: Changes in pulmonary function commonly occur after general surgery. The aims were to evaluate vital capacity, tidal volume and respiratory frequency among patients undergoing elective craniotomy and to determine possible correlations of these parameters with surgery duration and etiology for neurosurgery. DESiGN AND SETTiNG:Prospective, open study at a tertiary university hospital. METHODS:Twenty-six patients underwent elective craniotomy for aneurysm clipping (11) or tumor resection (15). Vital capacity (VC), tidal volume (TV), minute volume (VE) and respiratory rate were determined before the operation and on the first to fourth postoperative days.RESULTS: There were significant decreases of 25% in VC, 22% in TV and 12% in VE (p < 0.05) and no significant increase in respiratory frequency (5%) on the first postoperative day. VE returned to baseline on the second postoperative day and TV on the third postoperative day, while VC was 8% lower on the fourth postoperative day, compared with before the operation (p < 0.05). VC reduction was significantly greater in patients undergoing aneurysm clipping (43%) than in patients undergoing tumor resection (14%) when surgery duration was more than four hours (p < 0.05), with no significant change when surgery duration was less than four hours.CONCLUSiON: Reductions in VC, TV and VE were observed during the postoperative period in patients undergoing aneurysm clipping or tumor resection. The reductions in VC and TV were greater in patients undergoing craniotomy due to aneurysm and with longer surgery duration.

Introduction: Population ageing is a worldwide reality that requires attention, and a concern for healthy and functional ageing is increasingly the focus of government policies and programmes.Objective: To identify the prevalence of homebound elderly people, and the influence of sociodemographic and economic characteristics on their functional dependency. Methods:Cross-sectional study with 178 homebound elderly people assisted by a family healthcare unit in Vitória, ES, Brazil. Functional independence was measured by the Functional Independence Measure (FIM) and the sociodemographic and economic variables were collected by a questionnaire developed by the authors. Binary logistic regression was used to determine the influence of the sociodemographic and economic characteristics on the risk of being functionally dependent.Results: Forty-eight percent of the participants were functional dependents, 80% were female, 72% belonged to the fourth age, 74% were white, 63% were widowed, 78% had retired, 90% had children, 83% had a caregiver, 52% had low education and 40% had low income. Logistic regression indicated that having a caregiver increased by 40 times the chance of being functionally dependent (OR = 40.2; and having between one to eight years of education decreased the chance of functional dependency (OR = 0.2; 95%CI 0.04-0.9). Conclusions:The prevalence of functional dependency was very high in this sample, and since the presence of a caregiver was the strongest and significant predictor of functional dependency, we suggest that guidance and support should be offered to caregivers, followed by a family healthcare strategy, to make consistent efforts with the objective of improving functional recovery and independence of homebound elderly. Keywords Open acessSuggested citation: Pampolim G, Lourenço C, Silva VG, Coelho MCR, Sogame LCM. Prevalence and factors associated with functional dependency in homebound elderly people in Brazil. J Hum Growth Dev. 2017; 27(2): 235-243 J Hum Growth Dev. 2017; 27(2): 235-243 Prevalence and factors associated with functional dependency in homebound elderly people in BrazilIn the past few years, worldwide demographics have indicated intensive population ageing¹. In Brazil, according to the Brazilian Institute of Geography and Statistics, this ageing process has accelerated over the past decade and, by 2060, they expect that more than 30% of the Brazilian population will be 60 years old or more 2 . According to the Brazilian National Policy of Elderly Health, most of these elderly people will present some physical and/or mental disability that can impact upon their activities of daily living (ADLs). Therefore, the focus should be on the promotion of health and prevention of disabilities; this may be achieved through the Family Health Strategy (FHS) that works as a bridge between the health system and the elderly 3 , it has evolved into a robust approach to providing primary care for defined populations by deploying interdisciplinary health care teams. Family health t...

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