To define the epidemiological profile and the main determinants of morbidity and mortality in noncardiac high surgical risk patients in Brazil.
Methods:
This was a prospective, observational and multicenter study. All noncardiac surgical patients admitted to intensive care units, i.e., those considered high risk, within a 1-month period were evaluated and monitored daily for a maximum of 7 days in the intensive care unit to determine complications. The 28-day postoperative, intensive care unit and hospital mortality rates were evaluated.
Results:
Twenty-nine intensive care units participated in the study. Surgeries were performed in 25,500 patients, of whom 904 (3.5%) were high-risk (95% confidence interval – 95%CI 3.3% – 3.8%) and were included in the study. Of the participating patients, 48.3% were from private intensive care units, and 51.7% were from public intensive care units. The length of stay in the intensive care unit was 2.0 (1.0 – 4.0) days, and the length of hospital stay was 9.5 (5.4 – 18.6) days. The complication rate was 29.9% (95%CI 26.4 – 33.7), and the 28-day postoperative mortality rate was 9.6% (95%CI 7.4 – 12.1). The independent risk factors for complications were the Simplified Acute Physiology Score 3 (SAPS 3; odds ratio – OR = 1.02; 95%CI 1.01 – 1.03) and Sequential Organ Failure Assessment Score (SOFA) on admission to the intensive care unit (OR = 1.17; 95%CI 1.09 – 1.25), surgical time (OR = 1.001, 95%CI 1.000 – 1.002) and emergency surgeries (OR = 1.93, 95%CI, 1.10 – 3.38). In addition, there were associations with 28-day mortality (OR = 1.032; 95%CI 1.011 – 1.052), SAPS 3 (OR = 1.041; 95%CI 1.107 – 1.279), SOFA (OR = 1.175, 95%CI 1.069 – 1.292) and emergency surgeries (OR = 2.509; 95%CI 1.040 – 6.051).
Conclusion:
Higher prognostic scores, elderly patients, longer surgical times and emergency surgeries were strongly associated with higher 28-day mortality and more complications during the intensive care unit stay.
Silva Júnior JM, Chaves RCF, Corrêa TD, Assunção MSC, Katayama HT, Bosso FE, Amendola CP, et al. Epidemiology and outcome of high-surgical-risk patients admitted to an intensive care unit in Brazil. Rev Bras Ter Intensiva 2020;32(1):17-2.
Electronic Document Format (ABNT)
Silva Júnior, João Manoel; Chaves, Renato Carneiro de Freitas; Corrêa, Thiago Domingos; Assunção, Murillo Santucci Cesar de; Katayama, Henrique Tadashi; Bosso, Fabio Eduardo; Amendola, Cristina Prata; Serpa Neto, Ary; Malbouisson, Luiz Marcelo Sá; Oliveira, Neymar Elias de; Veiga, Viviane Cordeiro; Rojas, Salomón Soriano Ordinola; Postalli, Natalia Fioravante; Alvarisa, Thais Kawagoe; Lucena, Bruno Melo Nobrega de; Oliveira, Raphael Augusto Gomes de; Sanches, Luciana Coelho; Silva, Ulysses Vasconcellos de Andrade e; Nassar Junior, Antonio Paulo; Réa-Neto, Álvaro; Amaral, Alexandre; Teles, José Mário; Freitas, Flávio Geraldo Rezende de; Bafi, Antônio Tonete; Pacheco, Eduardo Souza; Ramos, Fernando José; Vieira Júnior, José Mauro; Pereira, Maria Augusta Santos Rahe; Schwerz, Fábio Sartori; Menezes, Giovanna Padoa de; Magalhães, Danielle Dourado; Castro, Cristine Pilati Pileggi; Henrich, Sabrina Frighetto; Toledo, Diogo Oliveira; Parra, Bruna Fernanda Camargo Silva; Dias, Fernando Suparregui; Zerman, Luiza; Formolo, Fernanda; Nobrega, Marciano de Sousa; Piras, Claudio; Piras, Stéphanie de Barros; Conti, Rodrigo; Bittencourt, Paulo Lisboa; D’Oliveira, Ricardo Azevedo Cruz; Estrela, André Ricardo de Oliveira; Oliveira, Mirella Cristine de; Reese, Fernanda Baeumle; Motta Júnior, Jarbas da Silva; Câmara, Bruna Martins Dzivielevski da; David-João, Paula Geraldes; Tannous, Luana Alves; Chaiben, Viviane Bernardes de Oliveira; Miranda, Lorena Macedo Araújo; Brasil, José Arthur dos Santos; Deucher, Rafael Alexandre de Oliveira; Ferreira, Marcos Henrique Borges; Vilela, Denner Luiz; Almeida, Guilherme Cincinato de; Nedel, Wagner Luis; Passos, Matheus Golenia dos; Marin, Luiz Gustavo; Oliveira Filho, Wilson de; Coutinho, Raoni Machado; Oliveira, Michele Cristina Lima de; Friedman, Gilberto; Meregalli, André; Höher, Jorge Amilton; Soares, Afonso José Celente; Lobo, Suzana Margareth Ajeje. Epidemiology and outcome of high-surgical-risk patients admitted to an intensive care unit in Brazil. Rev Bras Ter Intensiva, v. 32, n. 1, p. 17-27, May. 2020.
Electronic Document Format (APA)
Silva Júnior, J. M., Chaves, R. C. F., Corrêa, T. D., Assunção, M. S. C. , Katayama, H. T., Bosso, F. E., Amendola, C. P., Serpa Neto, A., Malbouisson, L. M. S., Oliveira, N. E. , Veiga, V. C., Rojas, S. S. O., Postalli, N. F., Alvarisa, T. K., Lucena, B. M. N. , Oliveira, R. A. G. , Sanches, L. C., Silva, U. V. A. , Nassar Junior, A. P., Réa-Neto, , Amaral, A., Teles, J. M., Freitas, F. G. R. , Bafi, A. T., Pacheco, E. S., Ramos, F. J., Vieira Júnior, J. M., Pereira, M. A. S. R., Schwerz, F. S., Menezes, G. P. , Magalhães, D. D., Castro, C. P. P., Henrich, S. F., Toledo, D. O., Parra, B. F. C. S., Dias, F. S., Zerman, L., Formolo, F., Nobrega, M. S., Piras, C., Piras, S. B., Conti, R., Bittencourt, P. L., D’Oliveira, R. A. C., Estrela, A. R. O., Oliveira, M. C. , Reese, F. B., Motta Júnior, J. S., Câmara, B. M. D. , David-João, P. G., Tannous, L. A., Chaiben, V. B. O., Miranda, L. M. A., Brasil, J. A. S., Deucher, R. A. O., Ferreira, M. H. B., Vilela, D. L., Almeida, G. C. , Nedel, W. L., Passos, M. G. , Marin, L. G., Oliveira Filho, W. , Coutinho, R. M., Oliveira, M. C. L. , Friedman, G., Meregalli, A., Höher, J. A., Soares, A. J. C., & Lobo, S. M. A. (2020). Epidemiology and outcome of high-surgical-risk patients admitted to an intensive care unit in Brazil. Rev Bras Ter Intensiva, 32(1), 17-27.
Electronic Document Format (ISO)
Silva Júnior, João Manoel and Chaves, Renato Carneiro de Freitas and Corrêa, Thiago Domingos and Assunção, Murillo Santucci Cesar de and Katayama, Henrique Tadashi and Bosso, Fabio Eduardo and Amendola, Cristina Prata and Serpa Neto, Ary and Malbouisson, Luiz Marcelo Sá and Oliveira, Neymar Elias de and Veiga, Viviane Cordeiro and Rojas, Salomón Soriano Ordinola and Postalli, Natalia Fioravante and Alvarisa, Thais Kawagoe and Lucena, Bruno Melo Nobrega de and Oliveira, Raphael Augusto Gomes de and Sanches, Luciana Coelho and Silva, Ulysses Vasconcellos de Andrade e and Nassar Junior, Antonio Paulo and Réa-Neto, Álvaro and Amaral, Alexandre and Teles, José Mário and Freitas, Flávio Geraldo Rezende de and Bafi, Antônio Tonete and Pacheco, Eduardo Souza and Ramos, Fernando José and Vieira Júnior, José Mauro and Pereira, Maria Augusta Santos Rahe and Schwerz, Fábio Sartori and Menezes, Giovanna Padoa de and Magalhães, Danielle Dourado and Castro, Cristine Pilati Pileggi and Henrich, Sabrina Frighetto and Toledo, Diogo Oliveira and Parra, Bruna Fernanda Camargo Silva and Dias, Fernando Suparregui and Zerman, Luiza and Formolo, Fernanda and Nobrega, Marciano de Sousa and Piras, Claudio and Piras, Stéphanie de Barros and Conti, Rodrigo and Bittencourt, Paulo Lisboa and D’Oliveira, Ricardo Azevedo Cruz and Estrela, André Ricardo de Oliveira and Oliveira, Mirella Cristine de and Reese, Fernanda Baeumle and Motta Júnior, Jarbas da Silva and Câmara, Bruna Martins Dzivielevski da and David-João, Paula Geraldes and Tannous, Luana Alves and Chaiben, Viviane Bernardes de Oliveira and Miranda, Lorena Macedo Araújo and Brasil, José Arthur dos Santos and Deucher, Rafael Alexandre de Oliveira and Ferreira, Marcos Henrique Borges and Vilela, Denner Luiz and Almeida, Guilherme Cincinato de and Nedel, Wagner Luis and Passos, Matheus Golenia dos and Marin, Luiz Gustavo and Oliveira Filho, Wilson de and Coutinho, Raoni Machado and Oliveira, Michele Cristina Lima de and Friedman, Gilberto and Meregalli, André and Höher, Jorge Amilton and Soares, Afonso José Celente and Lobo, Suzana Margareth Ajeje. Epidemiology and outcome of high-surgical-risk patients admitted to an intensive care unit in Brazil. Rev Bras Ter Intensiva [online]. 2020, vol. 32, n. 1, [cited 2024-05-08], pp.17-27. Available from: <https://criticalcarescience.org/article/epidemiology-and-outcome-of-high-surgical-risk-patients-admitted-to-an-intensive-care-unit-in-brazil/>.
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Figura 1 | Fluxograma dos participantes do estudo. UTI - unidade de terapia intensiva.
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