Gulini Juliana El Hage Meyer de Barros, Nascimento Eliane Regina Pereira do, Moritz Rachel Duarte, Vargas Mara Ambrosina de Oliveira, Matte Darlan Laurício, Cabral Rafael Pigozzi
Universidade Federal de Santa Catarina; Hospital Universitário, Florianópolis, SC, Brasil.
Universidade Federal de Santa Catarina, Departamento de Enfermagem, Programa de Pós-Graduação em Enfermagem, Florianópolis SC, Brasil.
Rev Esc Enferm USP. 2018 Jun 25;52:e03342. doi: 10.1590/S1980-220X2017023203342.
To identify predictors of death in the Intensive Care Unit and relate eligible patients to preferential palliative care.
A prospective cohort study that evaluated patients hospitalized for more than 24 hours, subdivided into G1 (patients who died) and G2 (patients who were discharged from hospital). For identifying the predictors for death outcome, the intensivist physician was asked the "surprise question" and clinical-demographic data were collected from the patients. Data were analyzed by descriptive/inferential statistics (p<0.05 significance).
170 patients were evaluated. The negative response to the "surprise question" was related to death outcome. A greater possibility of death (p<0.05) was observed among older and more frail patients with less functionality, chronic cardiac and/or renal insufficiencies or acute non-traumatic neurological insult, with multiorgan failure for more than 5 days, and hospitalized for longer.
Predictors of death were related to a subjective evaluation by the physician, the clinical condition of the patient, underlying diseases, the severity of the acute disease and the evolution of the critical illness. It is suggested that patients with two or more predictive criteria receive preferential palliative care.
确定重症监护病房（ICU）患者的死亡预测因素，并使符合条件的患者接受优先姑息治疗。
一项前瞻性队列研究，评估住院超过24小时的患者，分为G1组（死亡患者）和G2组（出院患者）。为确定死亡结局的预测因素，向重症医学医生询问“意外问题”，并收集患者的临床人口统计学数据。采用描述性/推断性统计学方法分析数据（p<0.05为有统计学意义）。
共评估了170例患者。对“意外问题”的否定回答与死亡结局相关。年龄较大、身体更虚弱、功能较差、患有慢性心脏和/或肾功能不全或急性非创伤性神经损伤、多器官功能衰竭超过5天以及住院时间较长的患者死亡可能性更大（p<0.05）。
死亡预测因素与医生的主观评估、患者的临床状况、基础疾病、急性疾病的严重程度以及危重病的进展有关。建议具有两个或更多预测标准的患者接受优先姑息治疗。
