Dados do Trabalho

Título

From clinical wards to intensive care unit: basic hemodynamic monitoring as a prognostic tool

Objetivo

This study aimed to evaluate the characteristics of patients admitted late to the Intensive Care Unity (ICU) and identify the main factors that contributed to the admission.

Métodos

Case-control study conducted in a tertiary hospital, with 4 years of follow-up (using medical records). The study included patients admitted to clinical wards with a risk for deterioration. Patients receiving palliative care were excluded. The patients were compared in terms of whether they needed ICU admission or not.

Resultados

We included 170 patients aged 60.6 ± 13.6 years. Of all patients, 56.5% required ICU admission on average on the 3rd day of admission. In the multivariate analysis, the qSOFA and the Charlson Comorbidity Index values were found to be independent factors in determining whether the patient required ICU admission (OR = 8.25, CI 95% = 4.4–15.3 and OR = 1.37, CI 95% = 1.03–1.82, respectively); the ROC value was 0.89 (95% CI 0.83–0.93). In the analysis of 90-day survival assessed by the Cox model, only qSOFA was strongly associated with shorter survival, the higher the value, (qSOFA = 1, HR = 9.42, P = 0.03; qSOFA = 2, HR = 17.7, P = 0.005; and qSOFA = 3, HR = 73.7, P < 0.001).

Conclusão

Selecting high-risk patients for ICU admission is a difficult task, and qSOFA appears to be a useful tool in differentiating patients and may help to better characterize this population.