Profile and severity of the patients of intensive care units: prospective application of the APACHE II index

Abstract

This study aimed to understand the profile and severity of patients in physiotherapy treatment after their admission to the intensive care unit (ICU) by applying the APACHE II index. One hundred and forty six subjects, with a mean age of 60.5 ± 19.2 years, were evaluated. The APACHE II index was applied in the first 24 hours to evaluate the severity and mortality risk score. Patients were monitored until hospital discharge or death. The mean APACHE II score was 20±7.3 with an estimated risk of death of 32.4% and observed mortality of 58.2%. The mean hospital stay was 27.8±25.2 days. The patients in physiotherapy at the institution studied were predominantly male, elderly, from the emergency service for treatment (non-surgical), and had clear severity, suggested by the APACHE II score and the observed mortality.Descriptors: APACHE; Mortality; Intensive Care Units. Perfil y gravedad de los pacientes de las unidades de terapia intensiva: aplicación prospectiva del puntaje APACHE IIEste estudio tuvo como objetivo conocer el perfil y la gravedad de pacientes asistidos por la fisioterapia, después de su ingreso en las unidades de terapia intensiva (UTI), a través de la aplicación del puntaje APACHE II. Se evaluaron 146 individuos con promedio de edad de 60,5±19,2 años. El puntaje APACHE II fue aplicado en las primeras 24h para evaluar la gravedad y dar puntuación al riesgo de mortalidad. Los pacientes fueron acompañados hasta el momento del alta hospitalaria o de la muerte. El puntaje APACHE II promedio fue de 20±7,3 con riesgo estimado de muerte de 32,4% y mortalidad observada de 58,2%. El promedio de permanencia hospitalaria fue de 27,8±25,2 días.En los pacientes asistidos por la fisioterapia de la institución investigada, el predominio fue del sexo masculino, ancianos, provenientes de la atención rápida para tratamiento clínico (no quirúrgico) y que presentan nítida gravedad, sugerida por el puntaje APACHE II y por la mortalidad observada.

Análise de eventos adversos em pacientes internados em unidade de terapia intensiva

“…(5,13) One of the reasons that may justify this result is the lack of a semi-intensive unit in the hospital assessed, which means that less critical patients are admitted in the ICU. However, the most severe patients assessed by APACHE II experienced more AE, a similar result to the ones found in national literature.…”

“…One of them is the prognostic index Acute Physiology and Chronic Health Evaluation II (APACHE II), developed to estimate severity of disease and predict hospital mortality. (5) Another instrument is the Nursing Activities Score (NAS), which measures the nursing workload including direct care actions, family support and management activities. (6) NAS monitoring allows determining the nursing team staffing in order to provide the necessary care.…”

Avaliação funcional de pacientes internados na Unidade de Terapia Intensiva adulto do Hospital Universitário de Canoas

“…However, the incidence of complications resulting from deleterious effects of immobility in Intensive Care Units (ICUs) is related to the decline of functional independence, excessive welfare costs, decreased quality of life, and post-discharge survival 1 .…”

Carga de trabalho de enfermagem em unidade de recuperação pós-anestésica

“…A study conducted at the intensive care unit of a nonprofit hospital in the state of Paraná assessed patient severity by means of the APACHE II score .The results showed that patients over the age of 60 years were more likely to have comorbidities. (13) A study conducted at the intensive care unit of a university hospital in São Paulo assessed differences in nursing workload (NAS) and severity (SAPS II) among elderly and non-elderly patients. The authors found that nursing workload was no different among elderly patients of different age ranges, but patients aged 80 or older had the highest severity indices (66.7%).…”