Avaliação dos óbitos ocorridos no Hospital Universitário da Universidade Federal de Santa Catarina (HU/UFSC)

Moritz, Rachel Duarte; Beduschi, Guilherme; Machado, Fernando Osni

doi:10.1590/s0104-42302008000500009

Cited by 8 publications

(8 citation statements)

References 12 publications

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“…Particularly, hypertension has been prevalent among individuals with a mean age 44, whereas the mean age for diabetes is 49 years old [28]. Similar to other studies, we observed higher mortality among male patients (62.1%) [22][23][24], inpatients transferred to the ICU (18.2%), and diagnosed with sepsis (41.9%). ose findings are 2.5 times higher than those observed in multicentric studies conducted in 65 ICU from all Brazilian territory where mortality rates by sepsis alone were 16.7% [29].…”

Section: Discussionsupporting

confidence: 87%

“…Charlson score, and constant need for invasive procedures and antibiotics that ultimately jeopardize natural immune response and cultiminate in death [29,30]. e type of care before ICU admission was mentioned by other researchers as potentially increasing the risk of death, and as once transferred to the ICU, individuals required critical hemodynamic care and constant surveillance [23]. Dehydration, tube feeding, and use of anticonvulsant drugs were associated with mortality in this study.…”

Section: Discussionmentioning

confidence: 66%

“…e adjusted model described the association between older age and prevalence of mortality. Other studies identified similar relationship in ICU patients; however, the risk of death was linked to elderly patients [1,2,23,25,27]. Incidence of chronic diseases among younger adults has been observed in Brazil.…”

Section: Discussionmentioning

confidence: 70%

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Mortality Predictors and Associated Factors in Patients in the Intensive Care Unit: A Cross-Sectional Study

Pinheiro

Santana–Santos

Barreto

et al. 2020

Critical Care Research and Practice

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Background. Mortality in the intensive care unit (ICU) has been associated to an array of risk factors. Identification of risk factors potentially contribute to predict and reduce mortality rates in the ICU. The objectives of the study were to determine the prevalence and the factors associated with the mortality and to analyze the survival. Method. A cross-sectional study conducted in two clinical and surgical ICU in the state of Sergipe, northeastern Brazil. We enrolled 316 patients with at least 48 h of hospitalization, minimum age of 18 years old, sedated or weaned, with RASS ≥ −3, between July 2017 and April 2018. We categorized data in (1) age and gender, (2) clinical condition, and (3) prevalence of delirium. Data from enrolled patients were collected from enrollment until death or ICU discharge. Patients’ outcomes were categorized in (1) death and (2) nondeath (discharge). Results. Twenty-one percent of participants died. Age (53 ± 17 years vs. 45 ± 18 years, p<0.01), electrolyte disturbance (30.3% vs 18.1%, p=0.029), glycemic index (33.3% vs 18.2%, p=0.008), tube feeding (83.3% vs 67.1%, p=0.01), mechanical ventilation (50% vs 35.7%, p=0.035), sedation with fentanyl (24.2 vs 13.6, p=0.035), use of insulin (33.8% vs 21.7%, p=0.042), and higher Charlson score (2.61 vs 2.17, p=0.041) were significantly associated with death on the adjusted model. However, the regression model indicated that patients admitted from the emergency (HR = 0.40, p=0.006) and glycemic index alterations (HR = 1.68, p=0.047) were associated with mortality. There was no statistically significant difference (p=0.540) in survival between patients with and without delirium, based on the survival analysis and length of hospitalization. Conclusion. The prevalence of death was 21%, and age, electrolyte disturbance, glycemic index, tube feeding, mechanical ventilation, sedation with fentanyl, use of insulin, and higher Charlson score were associated with mortality.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 66%

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Mortality Predictors and Associated Factors in Patients in the Intensive Care Unit: A Cross-Sectional Study

Pinheiro

Santana–Santos

Barreto

et al. 2020

Critical Care Research and Practice

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“…Specific ethical standards in force in Brazil on DNR were not found, but the procedure is evident in the hospitals, as attest the registers in medical records 9 . In that context, the aim of this research was to learn about the physicians' perspective on DNR and the need for ethical regulation.…”

Section: Terminally Ill Patients' Do Not Resuscitate Orders From the mentioning

confidence: 99%

Ordem de não reanimar pacientes em fase terminal sob a perspectiva de médicos

2016

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The do-not-resuscitate order is the explicit statement by patients with advanced disease in progression refusing cardiopulmonary resuscitation. This study aimed to describe the attitude of physicians in relation to the this order and the need for its regulation. A questionnaire was applied to 80 physicians in the medical bureau of the Regional Council of Medicine of Joacaba/SC, Brazil. It was found that 90% of the respondents knew the meaning of do-not-resuscitate, 86.2% agreed to respect it, 91.2% considered it important to be registered in medical records and 92.5% understood as opportune the issuance of a regulation in this regard. It was concluded that most doctors knew about the do-not-resuscitate order, agreed to respect it, valued its registration in medical records and wanted its regulation by the relevant bodies. Keywords: Terminally ill. Bioethics. Resuscitation orders. Heart massage. Respiration, artificial. Medical futility. ResumoOrdem de não reanimar pacientes em fase terminal sob a perspectiva de médicos Ordem de não reanimar consiste na manifestação expressa da recusa de reanimação cardiopulmonar por paciente com doença avançada em progressão. Objetivou-se descrever a atitude dos médicos em relação à ordem de não reanimar e à necessidade de sua normatização. Foi aplicado questionário a 80 médicos inscritos na delegacia do Conselho Regional de Medicina de Joaçaba/SC, Brasil. Verificou-se que 90% dos participantes conheciam o significado dessa ordem, 86,2% concordavam em acatá-la, 91,2% consideravam importante seu registro em prontuário e 92,5% consideravam oportuna a emissão de normatização a respeito. Concluiu-se que a maioria dos médicos tinha conhecimento sobre Ordem de Não Reanimar, concordava em respeitá-la, valorizava seu registro em prontuário e desejava a normatização por parte dos órgãos competentes. Palavras-chave: Doente terminal. Bioética. Ordens de não ressuscitar. Massagem cardíaca. Respiração artificial. Futilidade médica. ResumenLa orden de no reanimar a los pacientes en fase terminal bajo la perspectiva de los médicos La orden de no reanimar es la manifestación expresa de rechazo de la reanimación cardiopulmonar por parte de pacientes portadores de una enfermedad avanzada en progresión. Este estudio tuvo como objetivo describir la actitud de los médicos con respecto a esta orden y la necesidad de su regulación. Se aplicó un cuestionario a 80 médicos inscriptos en el distrito del Consejo Regional de Medicina de Joaçaba/SC, Brasil. Se encontró que el 90% de los encuestados conocían el significado de esta orden, el 86,2% estaban de acuerdo en cumplirla, el 91,2% consideraban importante el registro en el historial médico y el 92,5% juzgaban oportuna la existencia de una regulación al respecto. Se concluyó que la mayoría de los médicos tenía conocimiento de la orden de no reanimar, estaba de acuerdo en respetarla, valoraba su registro en el historial médico y deseaba su regulación por parte de las instituciones competentes. Palabras clave: Enfermo terminal. Bioética. Órdenes de...

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“…. Entretanto, mesmo não sendo oficialmente reconhecida, tal conduta é adotada na prática hospitalar 7,8 ,. Em geral, são ordens médicas verbais e informais de não reanimação, emitidas sem esclarecimento e obtenção de consentimento prévio, possivelmente para evitar desgaste emocional do paciente e da família 9 .…”

Section: Introductionunclassified

Ordem de não reanimar sob a perspectiva de pacientes oncológicos e seus familiares

Eidt

Bruneri²,

Bonamigo

2017

Mundo da Saúde

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This study aims to determine the perspective of oncological patients and their families in relation to the Do Not Resuscitate Order (DNR). A questionnaire was applied to 104 oncological patients and 100 relatives, who were attended to by the oncology service of Hospital Universitário Santa Terezinha, Joaçaba, Santa Catarina, Brazil in 2014. The term DNR was unknown by 81.73% of the patients and by 82% of the relatives. After clarifying its meaning, 65.4% of patients and 67% of the relatives were favorable towards DNR in the event of cardiorespiratory failure of the patient, in the final phase of the terminal disease. A shared decision between the patients, their relatives, and the doctor was preferred by 58.65% of patients and 73% of the relatives; a decision prompted by the initiative of the doctor accompanying the treatment was preferred by 60.58% of the patients and 72% of the relatives. The execution of the DNR by the patient him/herself was considered important by 63.47% of the patients and 68.63% of the relatives, and the introduction of the DNR in Brazil was considered important by 75% of the patients and 74% of the relatives. It is concluded that the majority of the patients and relatives did not know the term "Do Not Resuscitate Order", but were favorable to the introduction of the procedure in Brazil, the personal realization through the shared decision, and that the approach would occur during medical visits. The results of this study enable us to infer the need to broaden the discussion on DNR, in the ethical social scope, in order to issue guidance to ensure the autonomy of patients who are in the terminal phases of life. dos pacientes e 67% dos familiares mostraram-se favoráveis à ONR em caso de parada cardiorrespiratória de paciente em fase final de doença terminal. A decisão compartilhada entre pacientes, familiares e médico obteve a preferência de 58,65% dos pacientes e de 73% dos familiares, por iniciativa do médico que acompanha o tratamento, segundo 60,58% dos pacientes e 72% dos familiares. A realização de sua própria ONR foi considerada importante por 63,47% dos pacientes e 68,63% dos familiares e a implantação da Ordem de não reanimar no Brasil por 75% dos pacientes e 74% dos familiares. Concluiu-se que a maioria dos pacientes e familiares desconhecia os termos ordem de não reanimar, mas era favorável à implantação do procedimento no Brasil, à realização pessoal por meio de decisão compartilhada e que a abordagem ocorresse durante as consultas médicas. Os resultados deste estudo permitem inferir a necessidade de se ampliar a discussão sobre a Ordem de Não Reanimar, no âmbito ético e social, com a finalidade de se emitir orientações para assegurar a autonomia dos pacientes que se encontram na terminalidade da vida. Keywords Palavras-chave:

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Avaliação dos óbitos ocorridos no Hospital Universitário da Universidade Federal de Santa Catarina (HU/UFSC)

Cited by 8 publications

References 12 publications

Mortality Predictors and Associated Factors in Patients in the Intensive Care Unit: A Cross-Sectional Study

Mortality Predictors and Associated Factors in Patients in the Intensive Care Unit: A Cross-Sectional Study

Ordem de não reanimar pacientes em fase terminal sob a perspectiva de médicos

Ordem de não reanimar sob a perspectiva de pacientes oncológicos e seus familiares

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