Outcome After Admission in a Surgical Intensive Care Unit

Length of Stay, Mortality and Quality of Life

 

Fernando Abelha

Serviço de Anestesiologia, Hospital de São João, Porto

 

Outcome in intensive care can be categorized as mortality-related or morbidity-related. Hospital mortality is a relevant and objective endpoint. However, it is an insufficient indicator of Intensive Care unit (ICU) outcome and morbidity, disability and quality of life after discharge must also be taken into account. ICU length of stay (LOS) is often used as a surrogate for patient morbidity. Prolonged ICU stay can adversely affect prognosis by increasing the risk of complications such as infection and possibly, mortality. The study of quality of life after hospital discharge is increasingly used and accepted as a relevant measure of ICU outcome and appears as an important consideration when evaluating treatment benefits and resource allocation. It is important to understand quality of life in specific ICU subpopulations of critical ill patients and patients scheduled for elective surgery are of particular interest due to the individual risk of surgical procedures which may affect outcome.

Key-words: outcome; length of stay; mortality; quality of life.

 

Resultados Após Admissão em Cuidados Intensivos Cirúrgicos

A mortalidade intra-hospitalar é um resultado relevante e objectivo em Cuidados Intensivos (CI). Contudo, é um indicador insuficiente e por isso a morbilidade, o grau de dependência e a qualidade de vida após a alta dos CI devem ser avaliados. O tempo de internamento na Unidade de Cuidade de Intensivos (UCI) é frequentemente usado como um indicador indirecto de morbilidade. Tempos de internamento prolongados na UCI podem afectar de modo adverso o prognóstico e aumentar o risco de complicações como a infecção e mesmo a mortalidade. O estudo da qualidade de vida após a alta hospitalar é aceite como uma importante medida de resultados em CI sendo importante na avaliação da utilização de recursos e benefícios em CI. É importante compreender a qualidade de vida em sub populações específicas de doentes críticos; os doentes admitidos após cirurgia electiva representam um interesse particular pela possibilidade de categorizar o risco imposto pelos procedimentos cirúrgicos.

Palavras-chave: resultados; tempo de internamento; mortalidade; qualidade de vida.

 

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Correspondência:

Dr. Fernando Abelha

Serviço de Anestesiologia Hospital de São João Alameda

Prof. Hernâni Monteiro

4200-319 Porto

e-mail: abelha@mail.telepac.pt