Influence of sedation on morbidity and mortality in the intensive care unit
CONTEXT: Although 30 to 50% of hospitalized patients in a critical care unit are under sedation, there is sparse data on the impact of sedation on morbidity and case-fatality rates in Brazil. Sedation is associated with higher risks of infection and death rate among patients. However, it is difficul...
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| Format: | Article |
| Language: | English |
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Associação Paulista de Medicina
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| Series: | São Paulo Medical Journal |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802004000100003&lng=en&tlng=en |
| _version_ | 1818064696421384192 |
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| author | Geraldo Rolim Rodrigues Junior José Luiz Gomes do Amaral |
| author_facet | Geraldo Rolim Rodrigues Junior José Luiz Gomes do Amaral |
| author_sort | Geraldo Rolim Rodrigues Junior |
| collection | DOAJ |
| description | CONTEXT: Although 30 to 50% of hospitalized patients in a critical care unit are under sedation, there is sparse data on the impact of sedation on morbidity and case-fatality rates in Brazil. Sedation is associated with higher risks of infection and death rate among patients. However, it is difficult to assess the clinical impact of sedation. OBJECTIVE: To evaluate the impact of sedation on the incidence of nosocomial infection and all-cause deaths at a critical care unit. TYPE OF STUDY: Prospective study. SETTING: Tertiary-care teaching hospital. PARTICIPANTS: After the exclusion of patients hospitalized for less than 24 hours, 307 patients were assigned to two groups, considering their states of sedation. After confirmation of heterogeneity in relation to the Acute Physiology and Chronic Health Evaluation (APACHE II) prognostic system, 97 sedated and 97 non-sedated patients were matched in relation to this severity index. MAIN MEASUREMENTS: Impact of sedation on deep venous thrombosis, incidence of decubital eschars, presence of infection, mortality and length of hospital stay. RESULTS: There was no difference in the incidence of deep venous thrombosis between the sedated and non-sedated groups, while the frequency of decubital eschars was significantly higher among sedated patients (p = 0.03). Infection was detected in 45.4% of patients under sedation and 21.6% of patients not under sedation (p = 0.006). Mortality for patients that did not receive any kind of sedative was 20.6% and, for those that were sedated during hospitalization, the rate was 52.6% (p < 0.0001). The sedated patients had longer hospitalization (11 vs. 4 days) (p < 0.0001). CONCLUSION: We concluded that sedation is associated with higher infection risk and case-fatality rate, and longer hospital stay. |
| first_indexed | 2024-12-10T14:40:06Z |
| format | Article |
| id | doaj.art-4cc289f5b6b64445a1bd9ab3821f258d |
| institution | Directory Open Access Journal |
| issn | 1806-9460 |
| language | English |
| last_indexed | 2024-12-10T14:40:06Z |
| publisher | Associação Paulista de Medicina |
| record_format | Article |
| series | São Paulo Medical Journal |
| spelling | doaj.art-4cc289f5b6b64445a1bd9ab3821f258d2022-12-22T01:44:42ZengAssociação Paulista de MedicinaSão Paulo Medical Journal1806-9460122181110.1590/S1516-31802004000100003S1516-31802004000100003Influence of sedation on morbidity and mortality in the intensive care unitGeraldo Rolim Rodrigues Junior0José Luiz Gomes do Amaral1Universidade Estadual PaulistaUniversidade Federal de São PauloCONTEXT: Although 30 to 50% of hospitalized patients in a critical care unit are under sedation, there is sparse data on the impact of sedation on morbidity and case-fatality rates in Brazil. Sedation is associated with higher risks of infection and death rate among patients. However, it is difficult to assess the clinical impact of sedation. OBJECTIVE: To evaluate the impact of sedation on the incidence of nosocomial infection and all-cause deaths at a critical care unit. TYPE OF STUDY: Prospective study. SETTING: Tertiary-care teaching hospital. PARTICIPANTS: After the exclusion of patients hospitalized for less than 24 hours, 307 patients were assigned to two groups, considering their states of sedation. After confirmation of heterogeneity in relation to the Acute Physiology and Chronic Health Evaluation (APACHE II) prognostic system, 97 sedated and 97 non-sedated patients were matched in relation to this severity index. MAIN MEASUREMENTS: Impact of sedation on deep venous thrombosis, incidence of decubital eschars, presence of infection, mortality and length of hospital stay. RESULTS: There was no difference in the incidence of deep venous thrombosis between the sedated and non-sedated groups, while the frequency of decubital eschars was significantly higher among sedated patients (p = 0.03). Infection was detected in 45.4% of patients under sedation and 21.6% of patients not under sedation (p = 0.006). Mortality for patients that did not receive any kind of sedative was 20.6% and, for those that were sedated during hospitalization, the rate was 52.6% (p < 0.0001). The sedated patients had longer hospitalization (11 vs. 4 days) (p < 0.0001). CONCLUSION: We concluded that sedation is associated with higher infection risk and case-fatality rate, and longer hospital stay.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802004000100003&lng=en&tlng=enIntensive care unitComplicationsAPACHEMortality |
| spellingShingle | Geraldo Rolim Rodrigues Junior José Luiz Gomes do Amaral Influence of sedation on morbidity and mortality in the intensive care unit São Paulo Medical Journal Intensive care unit Complications APACHE Mortality |
| title | Influence of sedation on morbidity and mortality in the intensive care unit |
| title_full | Influence of sedation on morbidity and mortality in the intensive care unit |
| title_fullStr | Influence of sedation on morbidity and mortality in the intensive care unit |
| title_full_unstemmed | Influence of sedation on morbidity and mortality in the intensive care unit |
| title_short | Influence of sedation on morbidity and mortality in the intensive care unit |
| title_sort | influence of sedation on morbidity and mortality in the intensive care unit |
| topic | Intensive care unit Complications APACHE Mortality |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802004000100003&lng=en&tlng=en |
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