Preditores de mortalidade na unidade de terapia intensiva para pacientes adultos admitidos em ventilação mecânica: perfil de admissão

Abstract

Evaluating risk factors for mortality in local populations as the adult patients admitted in mechanical ventilation in Intensive Care Units (ICU) may provide support for management and improvements in outcomes in these units. The inclusion of the professional’s workload in these models has offered a different view of predictors. The aim of this study was to evaluate whether nursing workload evaluated by Nursing Activities Score (NAS), the predictors of mortality (APACHEII and SAPS3) and variables of admission for adult patients admitted to mechanical ventilation in an ICU are predictors of ICU mortality. We evaluated 194 patients who remained in mechanical ventilation for 48 hours before or after admission in ICU were evaluated in “Hospital de Clínicas de Uberlândia” ICU, a high complexity university hospital. The clinical and socio-demographic profile, nursing workload and some admission variables were evaluated. The outcomes discharge or death in the ICU was evaluated for all patients. We adopted simple or multiple logistic regression models defining protective or risk factors for ICU mortality. Only SAPS3 was a significant predictor for ICU mortality (OR = 1.03; IC95%: 1.01; 1.05), while the NAS from admission alone was not able to predict ICU mortality. In the multiple logistic model, the presence of chronic obstructive pulmonary disease (OR = 8.82; IC95%: 1.82; 42.70), the presence of thyroid diseases (OR = 5.98; IC95%: 1.15; 31.22) and the higher level of urea in the blood (OR = 1.01; IC95%: 1,002; 1.02) were the unique risk factors to ICU mortality. The admission variables of this population were more effective in predicting ICU mortality than the predictors of mortality evaluated here