Associação entre desfechos em saúde e assistência fisioterapêutica em pacientes internados com COVID-19
Association between health outcome and physiotherapeutic assistance in patients hospited with COVID-19
Ludmila Remígio de Almeida Carvalho, Cleilson Barbosa de Freitas, Edelvita Fernanda Duarte Cunha, Ádrya Aryelle Ferreira, Anna Cristina da Silva Santos, Anderson Bispo Coelho, João Paulo Coelho Guimarães, Rodrigo Souza Teixeira, Matheus Sobral Silveira, Paulo Adriano Schwingel, Fabianne Maisa de Novaes Assis Dantas, Victor Ribeiro Neves
Resumo
Introdução: A COVID-19 é uma doença de amplo espectro clínico, podendo possuir caracterização clínica e desfechos em saúde diversos. Objetivo: avaliar associações entre as características dos pacientes, os atendimentos fisioterapêuticos e os desfechos clínicos em pacientes internados com diagnóstico de COVID-19. Métodos: Realizado um estudo observacional transversal retrospectivo com prontuários de pacientes diagnosticados com COVID-19 internados na UTI entre março de 2020 a julho de 2021. Foram incluídos pacientes com idade igual ou superior a 18 anos, de ambos os sexos com teste positivo para COVID-19. Resultados: Foram avaliados 55 pacientes, destes, 60% eram homens, 95% pardos, 51% idosos (50,9%). Ainda, 56% eram hipertensos, 53% diabéticos, 33% obesos e 33% tabagistas. Adicionalmente, 52,7% dos pacientes foram submetidos a ventilação mecânica invasiva. Ao todo, 28 (50,9%) pacientes evoluíram para óbito. O risco de óbito revelou-se mais elevado para idosos (RC 4,22; IC de 95%: 1,37 – 13,03; p = 0,01) e para aqueles que tiveram a extubação não planejada (p = 0,01). Os pacientes que fizeram uso de oxigenoterapia por mais tempo (p=0,01) e que possuíam maior nível de mobilização (p=0,04) apresentaram maior probabilidade de alta. Conclusão: Idade avançada e extubação não planejada foram associadas com maior chance de óbito e as condutas fisioterapêuticas, em especial as que incluíam mobilização do paciente, revelaram associações com o desfecho alta.
Palavras-chave
Abstract
Background: COVID-19 is a disease with a broad clinical spectrum and may have different clinical characteristics and health outcomes. Aim: to evaluate associations between patient characteristics, physiotherapeutic care and clinical outcomes in patients hospitalized with a diagnosis of COVID-19. Methods: A retrospective cross-sectional observational study was carried out with medical records of patients diagnosed with COVID-19 admitted to the ICU between March 2020 and July 2021. Patients aged 18 years or over, of both sexes, who tested positive for COVID, were included. -19. Results: 55 patients were evaluated, of which 60% were men, 95% were mixed race, 51% were elderly (50.9%). Furthermore, 56% were hypertensive, 53% diabetic, 33% obese and 33% smokers. Additionally, 52.7% of patients underwent invasive mechanical ventilation. In total, 28 (50.9%) patients died. The risk of death was higher for the elderly (OR 4.22; 95% CI: 1.37 – 13.03; p = 0.01) and for those who had unplanned extubation (p = 0. 01). Patients who used oxygen therapy for a longer time (p=0.01) and who had a higher level of mobilization (p=0.04) were more likely to be discharged. Conclusion: Advanced age and unplanned extubation were associated with a greater chance of death and physiotherapeutic procedures, especially those that included patient mobilization, revealed associations with the discharge outcome.
DOI da versão traduzida: https://doi.org/10.47066/2966-4837.2024.0007en
Keywords
Referências
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Submetido em:
06/12/2023
Aceito em:
16/12/2024
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