Determinantes para Mortalidade Intra-hospitalar em Pacientes Oncológicos após Alta da Unidade de Terapia Intensiva
DOI:
https://doi.org/10.32635/2176-9745.RBC.2024v70n3.4812Palavras-chave:
Unidade de Terapia Intensiva, Mortalidade Hospitalar, Neoplasias/mortalidadeResumo
Introdução: Um número significante de pacientes com câncer morre após a alta da unidade de terapia intensiva (UTI). Entretanto, os fatores associados à mortalidade são pouco difundidos na literatura. Objetivo: Averiguar os fatores determinantes e identificar a frequência de mortalidade intra-hospitalar em pacientes oncológicos após alta da UTI para a enfermaria. Método: Estudo de coorte retrospectivo incluindo pacientes com câncer que receberam alta da UTI do Hospital do Câncer I do Instituto Nacional de Câncer entre 1 de janeiro de 2018 e 28 de dezembro de 2020. A associação entre as variáveis de exposição (clínicas e sóciodemográficas) e os desfechos (óbito) foi realizada pela regressão logística bruta e ajustada. Resultados: Foram incluídos no estudo 111 pacientes oncológicos sobreviventes da UTI. A mortalidade intra-hospitalar foi de 31,5% e o tempo médio de internação após a alta da UTI foi de 22,1 dias (±24,44). A análise múltipla revelou que os pacientes com escore final da ICU Mobility Scale (IMS) mais baixos no momento da alta da UTI (OR 0,7; IC 95%, 0,5-0,9; p = 0,01), a presença de metástases no momento da admissão na UTI (OR 2,8; IC 95%, 1,0-8,2; p = 0,04) e a internação por motivo clínico (OR 5,1; IC 95%, 1,7-15,8; p < 0,01) estavam associados à mortalidade intra-hospitalar. Conclusão: A presença de metástases na admissão da UTI, a internação por motivo clínico e a pior mobilidade no momento da alta estão relacionadas à mortalidade intra-hospitalar.
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