Estimativa do impacto econômico da implantação de um protocolo hospitalar para detecção e tratamento precoce de sepse grave em hospitais púbicos e privados do sul do Brasil

Köenig, Álvaro; Picon, Paulo Dornelles; Feijó, Janaína; Silva, Eliezer; Westphal, Glauco Adrieno

doi:10.1590/s0103-507x2010000300001

Cited by 19 publications

(17 citation statements)

References 14 publications

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“…Approximately R$ 17.3 billion are used annually in the treatment of septic patients, of which R$ 10 billion are targeted to patients progressing to death, generating economic impact (5,7) . The high mortality of septic shock and severe sepsis, and high costs associated with their treatment show the need for prevention and early diagnosis (8) . Therefore, knowing the costs generated by sepsis in health services can help to estimate the economic and social burden, and reinforces the importance of preventive measures.…”

Section: Introductionmentioning

confidence: 99%

Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization

Barreto

Dellaroza

Kerbauy

et al. 2016

Rev. esc. enferm. USP

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Objective: To estimate the cost of hospitalization of patients with severe sepsis or septic shock admitted or diagnosed in the Urgent and Emergency sector at a university hospital and followed until the clinical outcome. Method: An epidemiological, prospective, observational study conducted in a public hospital in southern Brazil for the period of one year (August 2013 to August 2014). Sepsis notification forms, medical records and data of the cost sector were used for the collection of clinical and epidemiological data. Results: The sample comprised 95 patients, resulting in a total high cost of hospitalization (R$ 3,692,421.00), and an average of R$ 38,867.60 per patient. Over half of the total value of the treatment of sepsis (R$ 2,215,773.50) was assigned to patients who progressed to death (59.0%). The higher costs were related to discharge, diagnosis of severe sepsis, the pulmonary focus of infection and the age group of up to 59 years. Conclusion: The high cost of the treatment of sepsis justifies investments in training actions and institution of protocols that can direct preventive actions, and optimize diagnosis and treatment in infected and septic patients. Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization Sepse em um hospital universitário: estudo prospectivo para análise de custo da hospitalização de pacientes Sepsis en un hospital universitario: estudio prospectivo para análisis de costo de la hospitalización de pacientes

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Section: Introductionmentioning

confidence: 99%

Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization

Barreto

Dellaroza

Kerbauy

et al. 2016

Rev. esc. enferm. USP

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“…34 In another study, the average length of stay before the introduction of the CSS resuscitation packages was 10.5 days in the United States and 22.8 days in Europe. 35 In this study, after the educational tool was introduced, the average length of stay was 7.7 days, which reflects the benefit for both the patient and the hospital, since shorter stays lead to a decreased costs. 36 In this study, the identification and early treatment by the use of the training strategy for patients with sepsis allowed a reduction in mortality to 30.6%, a result lower than that found in a cohort in Europe.…”

Section: Discussionmentioning

confidence: 80%

The Use of an Educational Tool to Improve Adjustment to the Sepsis Protocol and the Clinical Impact

Veríssimo¹,

Sobrinho²,

Andrade³

et al. 2017

NCOAJ

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Introduction: Sepsis is a major global health problem and is responsible for the deaths of thousands of people each year. It is the second leading cause of death in intensive care units, after coronary heart disease. Due to the high mortality rate, sepsis needs to be addressed through evidence-based practice, institutionalized protocols, well-developed clinical strategies, and continuing education. This study analyzed the clinical impact of adherence to an education tool for sepsis control measures at the Adventist Hospital of Belém in Brazil. Methodology:A prospective, quasi-experimental study was carried out from March to December 2015. The study included 152 patients diagnosed as having selection criteria with suspected sepsis. The patients diagnosed in the emergency department of the hospital were divided into a control group (n=30) and a case group (n=122) based on the period in which an educational tool was applied, for adherence to the hospital sepsis protocol. Results:The best adherence measure, after the tool application, was antimicrobial therapy. There was a reduction in the hospitalization time of the surviving patients from 19.7 days to 7.7 days and the mortality rate decreased from 63.3% to 30.6%. Conclusion:Although adherence to resuscitation packages was low, the education tool increased the insight of professionals in the identification of septic patients, resulting in a diagnosis and early treatment that corresponded with a reduction in hospitalization time and a decrease in mortality. The implementation of the educational tool and feedback letter was performed in August 2015. Patients admitted from March to July 2015, the period prior to the use of the tool, were eligible for participation in the control group, while patients admitted from August to December 2015 were eligible for participation in the case group. All adult patients greater than 18 years of age and diagnosed with sepsis, severe sepsis, and septic shock, admitted from the emergency department or transferred to the ICU within the first 24 hours of the diagnosis, were included in the study. The criteria for defining sepsis were based on the Sepsis Survival campaign (CSS) criteria. Obstetric patients, patients with sepsis referred from other institutions, and patients with organic dysfunctions not considered secondary to a chronic disease were excluded. KeywordsThe compilation of clinical and demographic data was conducted through the patients' clinical histories, using the form designed by the Institute Latin American Sepsis (ILAS) 9 and adapted by hospital quality management in conjunction with the Hospital Infection Control Committee (CCIH). From the time that the patient with suspected sepsis was admitted to the hospital, the CCIH team was activated and the data was collected using the pre-designed form. The evaluation was based on compliance with the updated CSS resuscitation package from 2012. The package also includes requirements that must be met within the first three and six hours, which are comprised of diagnosti...

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“…Nos EUA, a sepse é a 10ª causa de morte, sendo apontado por um estudo de fármaco-economia europeu um gasto direto de 23.000 a 34.000 euros. 7,8 Criado em 1995 e originalmente titulado do inglês de Sepsis-related Organ Failure Assessment (Avaliação Sequencial da Falên-cia Orgânica-SOFA), esse índice prognósti-co foi feito para a avaliação de morbidades em pacientes sépticos. Analisa seis sistemas orgânicos graduando entre 0 e 4 pontos de acordo com o grau de disfunção orgânica/ falência, assim como avaliar a eficácia das diversas terapêuticas utilizadas.…”

Section: Introductionunclassified

Aplicabilidade do índice SOFA em pacientes com sepse em uma Unidade de Terapia Intensiva de um Hospital na cidade de Fortaleza/CE

Evangelista

Neto

Magalhães

et al. 2018

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O índice SOFA tem na sua aplicação a avaliação das disfunções orgânicas, e a sepse como um agravante nas unidades de terapia intensiva, aumenta os episódios de falências orgânicas. Avaliar essa aplicabilidade em uma unidade crítica pode ser de grande relevância a equipe interdisciplinar que constantemente necessita de métodos auxiliares. Foram analisados pacientes com sepse, admitidos na unidade de terapia intensiva de um hospital público de Fortaleza, sendo coletados dados a partir do prontuário através de um estudo prospectivo, observacional do tipo censo entre novembro de 2011 a abril de 2012. Percebeu-se que referente às comorbidades, pouco delas foram apresentadas nos pacientes, vendo também, através do índice SOFA, uma comparação entre os dias coletados resultando em uma significância entre o 1º e o 3ª dia, levando esse resultado para uma vista estatística sobre a disfunção orgânica mais acometida. Como um recurso auxiliar em UTI, o índice SOFA torna-se possível a aplicação para aperfeiçoar a qualidade da avaliação e o acompanhamento junto ao paciente com sepse, e assim possibilitando com que as disfunções orgânicas sejam controladas facilmente. Ocasionando a diminuição das comorbidades e mortalidade, mas facilitando o prognóstico.

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Estimativa do impacto econômico da implantação de um protocolo hospitalar para detecção e tratamento precoce de sepse grave em hospitais púbicos e privados do sul do Brasil

Cited by 19 publications

References 14 publications

Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization

Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization

The Use of an Educational Tool to Improve Adjustment to the Sepsis Protocol and the Clinical Impact

Aplicabilidade do índice SOFA em pacientes com sepse em uma Unidade de Terapia Intensiva de um Hospital na cidade de Fortaleza/CE

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