ObjectiveTo assess the causes and factors associated with the death of patients between
intensive care unit discharge and hospital discharge.MethodsThe present is a pilot, retrospective, observational cohort study. The records of
all patients admitted to two units of a public/private university hospital from
February 1, 2013 to April 30, 2013 were assessed. Demographic and clinical data,
risk scores and outcomes were obtained from the Epimed monitoring system and
confirmed in the electronic record system of the hospital. The relative risk and
respective confidence intervals were calculated.ResultsA total of 581 patients were evaluated. The mortality rate in the intensive care
unit was 20.8% and in the hospital was 24.9%. Septic shock was the cause of death
in 58.3% of patients who died after being discharged from the intensive care unit.
Of the patients from the public health system, 73 (77.6%) died in the intensive
care unit and 21 (22.4%) died in the hospital after being discharged from the
unit. Of the patients from the Supplementary Health System, 48 (94.1%) died in the
intensive care unit and 3 (5.9%) died in the hospital after being discharged from
the unit (relative risk, 3.87%; 95% confidence interval, 1.21 - 12.36; p <
0.05). The post-discharge mortality rate was significantly higher in patients with
intensive care unit hospitalization time longer than 6 days.ConclusionThe main cause of death of patients who were discharged from the intensive care
unit and died in the ward before hospital discharge was septic shock. Coverage by
the public healthcare system and longer hospitalization time in the intensive care
unit were factors associated with death after discharge from the intensive care
unit.
BACKGROUND Systemic Lupus Erythematosus is a heterogeneous autoimmune disease with several clinical and laboratory manifestations. Vasculitis can affect 11-36% of these patients, and cutaneous involvement (small vessels) is the most common among them. However, we can not forget to make differential diagnosis with infections, for example.
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