Influence of sedation on morbidity and mortality in the intensive care unit.

Influence of sedation on morbidity and mortality in the intensive care unit.
复制标题

镇静对重症监护病房发病率和死亡率的影响。

DOI：
10.1590/s1516-31802004000100003
复制
发表时间：
2004
期刊：
Sao Paulo medical journal = Revista paulista de medicina
影响因子：
--
通讯作者：
J. L. D. do Amaral
J. L. D. do Amaral
中科院分区：
--
文献类型：
--
作者：
Geraldo Rolim Rodrigues Júnior;J. L. D. do Amaral

文献摘要

被引文献

相似文献

上下文 尽管重症监护室中30%至50%的住院患者处于镇静状态，但巴西关于镇静对发病率和病死率影响的数据很少。镇静剂与患者中较高的感染风险和死亡率相关。然而，很难评估镇静的临床影响。 目的 评价镇静对重症监护病房院内感染和全因死亡发生率的影响。 研究类型 前瞻性研究。 设置 三级护理教学医院。 参与者 在排除住院少于24小时的患者后，考虑到他们的镇静状态，将307例患者分为两组。在确认异质性的急性生理学和慢性健康评价（APACHE II）预后系统，97镇静剂和97非镇静剂患者进行了匹配的严重程度指数。 主要措施 镇静对深静脉血栓形成、褥疮发生率、感染发生率、死亡率和住院时间的影响。 结果 镇静组和非镇静组之间的深静脉血栓形成发生率没有差异，而镇静组患者的褥疮发生率显著较高（p = 0.03）。45.4%的镇静患者和21.6%的非镇静患者检测到感染（p = 0.006）。未接受任何镇静剂治疗的患者的死亡率为20.6%，住院期间接受镇静剂治疗的患者的死亡率为52.6%（p < 0.0001）。镇静患者的住院时间更长（11天对4天）（p < 0.0001）。 结论 我们的结论是，镇静与较高的感染风险和病死率，以及较长的住院时间。
CONTEXT Although 30 to 50% of hospitalized patients in a critical care unit are under sedation, there is sparse data on the impact of sedation on morbidity and case-fatality rates in Brazil. Sedation is associated with higher risks of infection and death rate among patients. However, it is difficult to assess the clinical impact of sedation. OBJECTIVE To evaluate the impact of sedation on the incidence of nosocomial infection and all-cause deaths at a critical care unit. TYPE OF STUDY Prospective study. SETTING Tertiary-care teaching hospital. PARTICIPANTS After the exclusion of patients hospitalized for less than 24 hours, 307 patients were assigned to two groups, considering their states of sedation. After confirmation of heterogeneity in relation to the Acute Physiology and Chronic Health Evaluation (APACHE II) prognostic system, 97 sedated and 97 non-sedated patients were matched in relation to this severity index. MAIN MEASUREMENTS Impact of sedation on deep venous thrombosis, incidence of decubital eschars, presence of infection, mortality and length of hospital stay. RESULTS There was no difference in the incidence of deep venous thrombosis between the sedated and non-sedated groups, while the frequency of decubital eschars was significantly higher among sedated patients (p = 0.03). Infection was detected in 45.4% of patients under sedation and 21.6% of patients not under sedation (p = 0.006). Mortality for patients that did not receive any kind of sedative was 20.6% and, for those that were sedated during hospitalization, the role was 52.6% (p < 0.0001). The sedated patients had longer hospitalization (11 vs. 4 days) (p < 0.0001). CONCLUSION We concluded that sedation is associated with higher infection risk and case-fatality rate, and longer hospital stay.