Perfil de pacientes encaminhados para a internação em UTI através da central de regulação de leitos de Fortaleza

Abstract

ABSTRACT PROFILE OF PATIENTS REFERRED TO THE HOSPITAL IN IN TENSIVE CARE UNIT ( ICU ) VIA THE ADJUSTMENT CENTER OF BEDS IN FORTALEZA . CRISTIANO WALTER MORAES RÔLA JÚNIOR. Thesis (MS). Post - Graduate Program in Pharmacology. Advisor: Prof. Dr. Manoel Odorico de Moraes. This study aimed at characterizi ng the profile of adult patients referred for admission in an intensive care unit through the Reference Center and Fortaleza Beds regulation and analyzing the outcome reached by them from October 2010 to September 2011. The method used was a descriptive, c ross - sectional, based upon a quantitative approach and a documentary nature. According to the data of the municipal system of beds Municipal regulation in Fortaleza, the statistical analysis for all admission requests were made in ICU totaling 5,975 patie nts whose profile was compiled in tables, graphs and charts with their absolute and relative frequencies check association among variables. Of all the requests, the demographics of the patients showed a predominance of males accounting for 59.41%; living i n Fortaleza 60.97% of patients and 49.18% were younger than 60 years. Among the patients referred, 32,12% did not receive formal prioritization by the medical regulator; however , among those who have been prioritized, the more patients corresponding to 64.69%, were classified as grade I and grade II 32.00% according to the criteria for admission to the ICU of the American Society of Intensive Care and used by CRRIFOR, totaling 96 .69% of all evaluated prioritization. Analysis of outcome and hospital destination of the patient at each level of prioritization were performed. Those patients who had received priority and had the highest percentage in access to ICU bed in hospital total led 47.05% of requests, followed by those with priority II reaching rates of 43.99%. The ICU mortality queue was higher in patients with priority III had a percentage of 52.17% evolved to death. Priority II patients showed the highest frequency of requests for admission to the ICU canceled due to change in the clinical status of patients, in 26.04% of the total. The Hospital Unit of reference that showed availability of ICU beds in this period was the General Hospital Waldemar Alcântara, rear unit that has no emergency sector, accounting for 19.96% of transfers in priority I patients and in patients . Priority II totaled 19.15% of patients transferred to ICU stay by CRRIFOR. Among the most frequent pathologies in ICU admission requests highlighted the stroke with 16.18%, respiratory infections caused by 8.30% and polytrauma with 7.95% to 32.43% of all requests. The average monthly requests for admissions to adult ICU in CRRIFOR was 498 patients and the average waiting time in the queue ICU was 5.66 days consi dering patients classified at all levels of priority. The Fortaleza beds Regulation Center contributed to improving the population's access to ICU beds of the public health system; however, there is the need of increasing the number of ICU beds in the stat e and public policies especially in the areas of neurology, cardiology and trauma. Intensive care must integrate a network of regionalized attention to health, so that the population may have an organized access ensuring universality, comprehensiveness and equity in health car.