Estado nutricional e mortalidade de pacientes críticos que reinternam em uma Unidade de Terapia Intensiva (UTI)

Abstract

The patient readmissions are important indicators of patient healthcare. Readimitted patients are more severe, older, more undernourished and have a higher risk of death. This was a cross-sectional retrospective clinical study which aimed to measure the nutritional status and mortality of critical patients who had been readmitted in ICU. Patients who had been readmitted in ICU in a private in the city of Cuiabá-MT, Brazil, with nutritional therapy in 2016 has been selected. The main variables were the nutritional status at admission and at patient discharge (determined by subjective global assessment) and the occurrence of death. The age of the patients was 66 (18-98) years old and 51,3% of them were male. At the readmission 64,1% of them were in nutritional risk or moderately undernourished (SGA=B) and 35,5% were severe malnourished (SGA=C). At the denouement (patient discharge, death or transfer) 56,4% of the patients was SGA=B and 43,6% SGA=C. Death occurrence was 40,2% and this patients had received less kcal/kg (24,4±4,3 vs 25,1±3,7; p=0,03), were more hyperglycemic (170±59,7 vs 146±43,5 mg/dL; p<0,001), with higher lactate value (24±14,9 vs 16,9±8,7mmol/L; p<0,001) and higher ratio PCR/Albumin (72,5±55,2 vs 43,5±43,2; p<0,001). The chance of death for patients with hyperglycemia (cut off, blood glucose≥150g/dL) was 2,1 times higher (OR=2,1; IC95% 1,23-3,7; p=0,006) and for the ones with hypoalbuminemia it was 1,8 times higher (cut off, albumina≤2,5g/dL) (OR=1,8; IC95% 1,03- 3,2; p=0,03). Of those critical patients who had been readmitted, the protein-energy malnutrition was present in 35% and the death has occurred in 40%.