Perfil epidemiológico das internações nas unidades de terapia intensiva de um município da região norte do Rio Grande do Sul

Abstract

Over the years, technology has gained notoriety and intensified in the field of health science, with great technological advances in order to provide adequate, effective and higher quality care. In this context, the Intensive Care Units (ICU) arise, in which they are highly complex environments in the hospital environment, with the objective of offering advanced life support for different levels of impairment in critically ill patients. The capacity to occupy ICU beds has been increasing in an exacerbated manner in recent years, aggravating the repressed future demand and showing a lack of care due to the overcrowding of health services. Another factor that must be considered is the effects of the demographic transition, linked to the reduction in the birth rate and the aging of the population, changing the epidemiological profile of patients admitted to the ICU. In this context, knowing the epidemiological profile of hospitalizations subsidizes the management and management of the service, improving the quality of care, the organization and the results achieved. The objective of the research was to analyze the epidemiological profile of hospital admissions in intensive care units in the city of Erechim, Rio Grande do Sul. Having as specific objectives to know the sociodemographic characteristics of the patients; identify the prevalence of causes of admissions and assess the clinical evolution of patients. The present study is a quantitative study, with a cross-sectional and retrospective design. For the research, secondary data referring to the registration information of patients admitted to one of the ICUs in the city were analyzed. This information was provided by hospital institutions without identifying patients and family members. The variables explored in the research were: age, sex, marital status, municipality of residence, reason for admission (ICD-10), and data regarding clinical evolution (discharge, transfer from unit or sector and deaths). Data were coded and analyzed in an Excel spreadsheet. Data analysis was performed using descriptive statistics of the variables. The results found in this research showed that among the total number of admissions from January 2010 to December 2020, the majority are elderly (≥ 60 years old), male and married/concubinate. It can be seen that transfers after the ICU period to other hospitalization sectors have higher proportions in young adults and decrease with increasing age groups. With regard to direct admissions to the ICU, the highest proportion is among the older/young population, relating to external causes (and others) and increased transfers from other inpatient units to the ICU among older people, as they have more chronic conditions, which generally complicate or worsen more slowly. Males had the highest number of discharges compared to females, being higher in single and separated patients, as this is a younger population. As for deaths, the highest percentage of mortality was in widowers. The municipality of Erechim had the highest hospitalization rates and, with regard to discharge indicators, the municipalities with the highest prevalence were Aratiba and Campinas do Sul. Considering the ICD-10 chapters, admissions in the 10-year period were mainly due to diseases of the circulatory system, followed by symptoms, signs and abnormal findings from clinical and laboratory tests, respiratory diseases, digestive diseases, injuries, poisoning and some external causes and neoplasms (tumors). The causes of death in the study period were infectious and parasitic diseases, among them unspecified sepsis having more proportion within the group, followed by respiratory diseases, in third place neoplasms (tumors), the fourth cause related to the genitourinary system, followed by diseases of the digestive tract. However, considering the order of classification of the specific causes of death in this study, without considering the ICD-10 chapter, it is worth noting that the causes of the circulatory system prevail. The main specific causes were cerebrovascular accident (CVA) not specified as hemorrhagic or ischemic, being the main cause of death in the ICU, and unspecified Acute Myocardial Infarction was the fifth most prevalent cause of death in the ICU in this study. Regarding the discharge variable, the patients with the best clinical evolution do those with the following ICD-10 Chapters: symptoms, signs and abnormal findings from clinical and laboratory examinations followed by diseases of the genitourinary system and in third place for the chapter of diseases of the digestive tract. Through this study, it was possible to know the epidemiological profile of admissions to the intensive care unit and may support the management of services and actions to improve health care.