Co-morbidade e mortalidade de pacientes em início de diálise

Abstract

RESUMOObjetivos: identificar a co-morbidade e causas de mortalidade dos pacientes em início de diálise e analisar se as variáveis pessoais, a comorbidade, os resultados laboratoriais, o número de dias de internação e número de sessões de diálise são fatores de risco para mortalidade. Métodos: foram incluídos no estudo 102 pacientes que iniciaram tratamento dialítico em um hospital universitário. Foi realizado um registro prospectivo de dados pessoais, laboratoriais, de morbidade e mortalidade. Resultados: a hipertensão e as infecções foram as principais causas de co-morbidade (58,8%). O sítio mais freqüente de infecção foi a corrente sangüínea em 30 (50%). Conclusão: a maioria dos pacientes que chegaram ao Serviço estava em urgência dialítica, o sítio de infecção mais freqüente foi a corrente sangüínea relacionado ao uso do cateter venoso central, o sexo masculino, a raça branca, a uremia e as morbidades hipertensão arterial e infecção, foram as que mais contribuíram para o aumento do risco de mortalidade. Descritores: Insuficiência renal crônica/mortalidade; Diálise renal; Mortalidade ABSTRACT Objectives: to identify to the co-morbity and causes of mortality of the patients in beginning of dialysis and to analyze if the personal variables, the co-morbity, the laboratory results, the number of days of internment and number of dialysis sessions are factors of risk for mortality. Methods: was included in this study 102 patients who had initiated dialysis treatment in a university hospital. The prospective record was realized to collect personals data, laboratory data, morbity and mortality. Results: the arterial hypertension and the infection was more frequent causes of co-morbity (58,8%). The infection locality more frequent was the blood circulation in 30 (50%).Conclusion: the majority of the patients who had arrived at the service was in dialysis urgency; the morbity most prevalent was the arterial hypertension and the infection; the infection locality more frequent was the blood circulation related to the use of the central venous catheter; and that the male sex, the white race, the uremia, and the morbity arterial hypertension and infection, had been the ones that more contributed for the increase of the mortality risk. Descriptors: Renal insufficiency, chronic/mortality ; Renal dialysis; Morbidity RESUMENObjetivos: identificar el co-morbidad y las causas de la mortalidad de los pacientes en el principio de la diálisis y analizar si resultan las variables personales, el co-morbidad, los dados laboratoriais, del número de días de la internación y del número de las sesiones de la diálisis son factores del riesgo para la mortalidad. Métodos: fueron incluido 102 pacientes en el estudio que habían iniciado el tratamiento de la diálisis en un hospital de la universidad. Fue realizado uno registro de los dados personales, laboratoriais, de la morbidad y de la mortalidad. Resultados: la hipertensión arterial y las infecciónes eram las más frecuente causas de la co-morbidad (58,8%). El local de la infección más frecue...

Diagnósticos de enfermagem identificados em pacientes hospitalizados durante sessões de hemodiálise

“…In this study, SAH and DM were found to be the prevalent comorbidities, followed by cardiovascular diseases, which is corroborated by other studies (23,24) . Among the studied patient, 55 (56.1%) of them presented SAH, which is evidence of the high prevalence of this disease in patients with renal diseases.…”

Avaliação do tipo de curativo utilizado em cateter venoso central para hemodiálise

“…The use of sterile transparent film is recommended to dress the site of catheter insertion among patients undergoing hemodialysis (4)(5) . The use of transparent film in dressings in central venous catheter for hemodialysis did not protect against infections when compared to normal dressings.…”

“…A recent study showed that in the population starting dialysis (n=106), the most common infection site was the blood stream related with the use of central venous catheter, which corresponds to 50% of the infections compared to other sites (4) . Bacteremia is the most severe catheter-related complication and it may evolve to endocarditis, significantly increasing morbidity and mortality of patients undergoing this therapy.…”

“…The most frequent microbiological agents in this infection are Staphylococcus aureus and coagulase-negative staphylococcus. These infections represent the second major cause of death among patients undergoing hemodialysis (4)(5) . Catheter dressing used in hemodialysis follow the same guidelines of central venous catheter dressing.…”

Adesão de portadores de insuficiência renal crônica ao tratamento de hemodiálise

“…When CRI is diagnosed, a conservative or dialysis treatment should be started as early as possible, otherwise, the complications can lead to death (2) .…”