AIH versus prontuário médico no estudo do risco de óbito hospitalar no infarto agudo do miocárdio no Município do Rio de Janeiro, Brasil

Abstract

The objective of this study was to analyze the usefulness of the Brazilian Hospital Information System (SIH) in comparison to medical records to study factors associated with in-hospital mortality due to acute myocardial infarction (AMI). We evaluated a stratified random sample of 391 medical records (out of 1,936 hospital admissions forms) with AMI as the primary diagnosis in the city of Rio de Janeiro. Factors associated with in-hospital death were studied through logistic modeling. Models were developed directly from the SIH and from medical records. ROC curves were constructed to allow comparison of the different models. We found an AMI diagnostic confirmation = 91.7% and hospital mortality = 20.6%. The logistic model derived from medical records produced the best fit (concordance = 90.1%). Although the SIH model had a worse fit (concordance = 70.6%), the correction of keying-in and information errors using data from medical records did not significantly modify its performance. Under-recording of secondary diagnosis was high in the SIH forms and was the main limiting factor.

Perfil das internações em Unidades de Terapia Intensiva Pediátrica do Sistema Único de Saúde no estado de Pernambuco, Brasil

“…The use of this system as a source of data for investigations is increasing due to its agile production and improvements of the database quality, in addition to the ease of access 21 . An exception to this is the primary diagnosis for admission and death, which is less reliable, especially when the cause is best especified 22,23 . To minimize the possibility of bias, it is recommended that the main diagnosis be grouped ac- cording to the chapters of ICD-10 24 , which was the strategy used in the current study.…”

Desigualdade no tratamento à fratura proximal de fêmur no Rio de Janeiro

“…Discute-se que os registros do sistema de informação para o ressarcimento das internações realizadas no SUS possam apresentar problemas de confiabilidade, tendendo a registrar procedimentos mais caros que os realizados na prática. No entanto, estudo recente mostrou elevada confiabilidade nos procedimentos médicos registrados nas internações de pacientes com infarto agudo do miocárdio 13 . Acredita-se que o mesmo tenha ocorrido no presente trabalho, uma vez que foi observada freqüência elevada de procedimentos não cirúrgicos, sabidamente de custos mais baixos que os procedimentos ortopédicos operatórios.…”

Atuação Do Enfermeiro No Atendimento De Emergência Ao Paciente Com Infarto Agudo Do Miocárdio

“…Dez anos atrás. Entre as causas de morte e hospitalização, a síndrome coronariana aguda (SCA) é a mais proeminente, incluindo infarto agudo do miocárdio (IAM) e angina instável (AI) (ESCOSTEGUY et al, 2005).…”