Long-term evaluation of critical care patients-preliminary results


Em: ESICM 22nd Annual Congress, 2009, Viena. (Poster Eletrônico)

Motivo: Produção Colaborador HMV

Setor HMV: CTI Adulto

Área da saúde: Medicina Intensiva

Resumo: INTRODUCTION. Functional status of individuals is a marker of quality of life. It is important to evaluate long term follow up from critically ill patients principally from those that leave the intensive Care Unit (ICU) and come back to society. OBJECTIVE. To assess the Follow up of survivors from 2 general ICU at least 18 months after ICU discharge and to evaluate factors associated with survival or death. METHOD. We analyzed all patients admitted in 2 general ICU during one year. During admission all descriptive data related to ICU hospitalization, including SOFA, APACHE II and TISS scores, were collected. In a second moment (18 - 46 months after discharge from ICU) a telephone interview with patients or their responsible was done. This interview evaluated if patients were still alive and assessed the functional status using the Karnofsky scale and the Activities for Daily Living (ADL) scale. RESULTS. From a total number of 1219 patients, 76.1% (n= 928) were discharged from ICU and 84.4% (n= 783) left the hospital. 26.3% (n= 206) died before the interview that occurred on average 27 months (± 9 months) after discharge from ICU. 34 subjects refused to participate and 35 were not found. Therefore 506 subjects answered the interview, 18% (n= 91) of them being evaluated before 24 months and 82% (n=415) being still alive after this period. Comparing your current health condition of the previous hospitalization in the ICU, the perception of the subjects was that 34% (n = 174) felt almost equal, 34% (n = 173) it was better and 31% felt is worse (p> 0.05). From all patients 48% (n=584) used mechanical ventilation (MV) having a survival rate in 24 months of 26.4% (n= 154). Renal replacement therapy (RRT) was used in 150 subjects, which survival rate at the 24th month was 20% (n= 30). Survivors were younger (61 years ±18 versus 6 years ± 7, p< 0001). APACHE II score was lower in survivors (12.55 ± 7.44 versus 18.97 ± 8.88, p< 0001). Sepsis was diagnosed in 25.7% (n= 313) having a death rate in 24 months of 80% (n= 252). CONCLUSION. This preliminary evaluation indicated that factors as MV, RRT APACHE score and sepses are associated with higher mortality in ICU. A great number of patients are still alive in 24 months. More analysis is needed for greater consistency of data.

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