Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942010000300006
Brazilian Journal of Anesthesiology
Scientific Article

Avaliação da qualidade de vida e mortalidade em pacientes com eventos cardíacos graves no pós-operatório

Quality of life and mortality assessment in patients with major cardiac events in the postoperative period

Fernando José Abelha; Miguela Botelho; Vera Fernandes; Henrique Barros

http://dx.doi.org/10.1590/S0034-70942010000300006 Braz J Anesthesiol, vol.60, n3, p.268-284, 2010
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Resumo

JUSTIFICATIVA E OBJETIVOS: Complicações cardiovasculares no pós-operatório associam-se a elevadas mortalidade e morbidade. Poucos estudos avaliaram o grau de dependência desses doentes e a percepção da sua saúde. O objetivo deste trabalho foi avaliar a mortalidade e a qualidade de vida em doentes que desenvolveram eventos cardíacos graves (EC) no pós-operatório. MÉTODO: Estudo retrospectivo numa Unidade de Tratamento Intensivo Cirúrgica (UTI-Cirúrgica), entre março de 2006 e março de 2008. Os doen tes foram avaliados quanto à ocorrência de EC. Seis meses após a alta, foi preenchido o questionário Short-Form-36 (SF-36) e avaliada a dependência nas atividades da vida diária (AVD). As comparações entre grupos independentes de doentes foram efetuadas com teste t de Student. A comparação entre cada variável e a ocorrência de EC foi efetuada por regressão logística envolvendo todos os doentes. RESULTADOS: Dos 1.280 doentes que apresentaram critérios de inclusão, 26 (2%) desenvolveram EC. A análise univariada identificou como determinantes independentes para o desenvolvimento de EC: estado físico ASA, hipertensão arterial, doença cardíaca isquêmica, doença cardíaca congestiva e escore do Índice de Risco Cardíaco Revisado. A mortalidade seis meses após alta da UTI-Cirúrgica foi de 35%. Dos 17 sobreviventes aos seis meses, 13 completaram os questionários. Trinta e um por cento referiram que sua saúde em geral era melhor no dia em que responderam ao questionário do que 12 meses antes. Sessenta e nove por cento dos doentes estavam dependentes nas AVD instrumentais e 15%, nas AVD pessoais. CONCLUSÕES: O desenvolvimento de EC tem sério impacto no tempo de hospitalização e nas taxas de mortalidade. Seis meses após a alta da UTI-Cirúrgica, mais de metade dos doentes estavam dependentes em pelo menos uma AVD instrumental.

Palavras-chave

CIRURGIA, CIRURGIA, CIRURGIA, COMPLICAÇÕES, COMPLICAÇÕES, COMPLICAÇÕES

Abstract

BACKGROUND AND OBJECTIVES: Cardiovascular complications in the postoperative period are associated with high mortality and morbidity. Few studies have assessed the degree of dependence in these patients and their perception of health. The objective of this study was to assess the mortality and the quality of life in patients who developed major cardiac events (MCE) in the postoperative period. METHOD: Retrospective study carried out in a Surgical Intensive Care Unit (SICU), between March 2006 and March 2008. The patients were assessed regarding the occurrence of CE. Six months after the hospital discharge, the Short-Form-36 (SF-36) questionnaire was filled out and dependence was assessed in relation to activities of daily living (ADL). The comparisons between independent groups of patients were carried out using Student's t test. The comparison between each variable and the occurrence of CE was carried out by logistic regression and included all patients. RESULTS: Of the 1,280 patients that met the inclusion criteria, 26 (2%) developed MCE. The univariate analysis identified as independent determinants for the development of major cardiac events: ASA physical status, hypertension, ischemic heart disease, congestive heart disease and score of the Revised Cardiac Risk Index (RCRI). The six-month mortality after the SICU discharge was 35%. Of the 17 surviving patients, 13 completed the questionnaires. Thirty-one percent of them reported that their general health was better on the day they answered the questionnaire, when compared to 12 months before. Sixty-nine percent of the patients were dependent in instrumental ADL e 15% in personal ADL. CONCLUSIONS: The development of MCE has a significant impact on the duration of hospital stay and mortality rates. Six months after the discharge from the SICU, more than 50% of the patients were dependent in at least one instrumental ADL.

Keywords

COMPLICATIONS, COMPLICATIONS, COMPLICATIONS, SURGERY, SURGERY

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