Mortalidad tras el alta de la Unidad de Cuidados Intensivos y factores pronósticos relacionados en una cohorte de pacientes críticos con disfunción multiorgánica

Hortigüela-Martín, V.A.; Sánchez-Casado, M.; Rodríguez-Villar, S.; Quintana-Díaz, Manuel; Marco-Schulke, C.M.; Gómez-Tello, V.; Martin, H; Arrese-Cosculluela, M. Ángeles

doi:10.1016/j.medcli.2012.09.043

Cited by 8 publications

(2 citation statements)

References 28 publications

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“…The factors that influenced hospital mortality were advanced age and generally decreased functional status, with both factors being non-modifiable. After discharge, the general functional status remained diminished along with re-hospitalizations (29) . One of the limitations of this investigation is the lack of follow-up of the patients in the study for a minimum period of 6 months after discharge which may constitute a study bias, as the death rate of patients who were discharged from ICU could be higher, and the "surprise question" could have presented even greater correct prediction.…”

Section: Discussionmentioning

confidence: 97%

Fatores preditores de óbito em Unidade de Terapia Intensiva: contribuição para a abordagem paliativista

Gulini

Nascimento

Moritz

et al. 2018

Rev. esc. enferm. USP

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RESUMO Objetivo Identificar preditores de óbito na Unidade de Terapia Intensiva e relacionar pacientes elegíveis para cuidados paliativos preferenciais. Método Coorte prospectivo que avaliou pacientes internados por mais de 24 horas, subdivididos em G1 (pacientes que morreram) e G2 (pacientes com alta hospitalar). Para a identificação dos fatores preditores para o desfecho óbito, foi feita ao médico intensivista a “pergunta-surpresa” e foram coletados dados clínico-demográficos dos pacientes. Os dados foram analisados por estatística descritiva/inferencial (significante p<0,05). Resultados Foram avaliados 170 pacientes. A resposta negativa à “pergunta-surpresa” foi relacionada ao desfecho óbito. Houve maior possibilidade de óbito (p<0,05) entre os pacientes mais velhos, mais frágeis, com menor funcionalidade, com insuficiências cardíaca e/ou renal crônicas ou insulto neurológico agudo não traumático, com falência multiorgânica por mais de 5 dias, internados por mais tempo. Conclusão Preditores de óbito foram relacionados à avaliação subjetiva do médico, à condição clínica do paciente, às doenças de base, à gravidade da doença aguda e à evolução da doença crítica. Sugere-se que pacientes com dois ou mais critérios preditores recebam cuidados paliativos preferenciais.

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Section: Discussionmentioning

confidence: 97%

Fatores preditores de óbito em Unidade de Terapia Intensiva: contribuição para a abordagem paliativista

Gulini

Nascimento

Moritz

et al. 2018

Rev. esc. enferm. USP

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“…To date, several studies previously focused on the risk of mortality after ICU hospitalization [1–4]. However, less attention has been given to morbidity and health-related quality of life (HRQoL) of patients who survive the initial critical event.…”

Section: Introductionmentioning

confidence: 99%

Clinical Utility of a Structured Program to Reduce the Risk of Health-Related Quality of Life Impairment after Discharge from Intensive Care Unit: A Real-World Experience

Venni

Ioia

Laviola

et al. 2018

Critical Care Research and Practice

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Background Postdischarge deterioration in health-related quality of life (HRQoL) is a major clinical issue for patients after an intensive care unit (ICU) hospitalization. A significant proportion of these patients is known to develop a progressive worsening of mental and physical performance—the so-called post-intensive care syndrome (PICS). Aim We aimed at exploring the effects of a structured program for the management of ICU patients, aimed at improving postdischarge HRQoL and reducing the risk of PICS. Methods A total of 159 patients hospitalized in our ICU with a length of stay >72 hours were enrolled in an institutional management protocol including specific recommendations: adequate sedation and analgesia protocols, to ensure a valid delirium prevention strategy, and to provide a planned midterm after discharge. The main endpoint was the occurrence of PICS at the 6-month follow-up visitation, defined as an abnormal physical or mental score in the SF-12 questionnaire in the presence of clinical evidence of new or worsening impairment in physical, cognitive, or mental health status. An additional questionnaire was administered, to assess the effects of ICU-related memories. Results Most patients positively rated their health at the 6-month follow-up and had no significant impairment in physical or mental health status. The mean normalized values of the physical and mental component of the SF-12 score were 46 ± 11 and 48 ± 14, suggesting a normal physical and mental health status in most patients. Twenty-nine patients (18.2%) showed evidence of PICS. Similar good results were found by the questionnaire of memories. In multivariable analysis, no variable was found to predict the risk of PICS in our population. Conclusion In this real-world analysis that lacks a control group, patients who used a program aimed at minimizing the risk of HRQoL deterioration and PICS reported a good perception of their state of health with a relatively low prevalence of PICS.

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Considerations in Organ Failure

Ortíz-Leyba

2014

Surgical Metabolism

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Mortalidad tras el alta de la Unidad de Cuidados Intensivos y factores pronósticos relacionados en una cohorte de pacientes críticos con disfunción multiorgánica

Cited by 8 publications

References 28 publications

Fatores preditores de óbito em Unidade de Terapia Intensiva: contribuição para a abordagem paliativista

Fatores preditores de óbito em Unidade de Terapia Intensiva: contribuição para a abordagem paliativista

Clinical Utility of a Structured Program to Reduce the Risk of Health-Related Quality of Life Impairment after Discharge from Intensive Care Unit: A Real-World Experience

Considerations in Organ Failure

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