Epidemiologia, lesão inalatória e biomarcadores: relação com prognóstico de adultos queimados internados em uma unidade de referência
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Data
2009-11-23
Autores
Rosa, Deborah Maciel Cavalcanti [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Diferentemente do que em países desenvolvidos nos quais tem havido redução do número, da morbidade e da mortalidade dos casos de queimadura, nos países em desenvolvimento estas taxas ainda são muito elevadas. Embora a queimadura seja um problema muito freqüente no Brasil, existem poucos estudos e dados epidemiológicos disponíveis. O presente trabalho teve como objetivos descrever a epidemiologia, identificar variáveis epidemiológicas e clínicas que influenciam no prognóstico de adultos queimados e fatores prognósticos. Estudo observacional, prospectivo, casos consecutivos de pacientes queimados com idade igual ou superior a 18 anos, internados na Unidade de Tratamento de Queimados (UTQ) de um hospital geral universitário de nível terciário, localizado na região centro-oeste do Estado de São Paulo, sudeste do Brasil, que atende exclusivamente pacientes do Sistema Único de Saúde, no período de maio de 2006 a julho de 2007. Dos prontuários e do exame clínico dos pacientes foram extraídos os seguintes dados: sexo, idade, características da queimadura (agente, causa, extensão e profundidade), intervalo de tempo entre a queimadura e a internação, presença de lesão inalatória, complicações e tempo de permanência. Em um grupo de 25 pacientes foi possível a dosagem sérica de dímero D e de proteína C reativa nas primeiras 48 horas e no 7º dia após a queimadura. O desfecho final considerado foi alta hospitalar ou óbito. Foi realizada comparação entre os grupos de acordo com o desfecho, sendo as variáveis quantitativas analisadas pelos testes t de Student, teste de Wilcoxon ou das medianas para amostras independentes, dependendo da normalidade dos dados, e as variáveis qualitativas pelo teste de diferença de proporções. Considerando o desfecho como variável resposta, foi ajustada uma regressão logística em função das variáveis clínicas...
Differently from developed countries in which there have been a reduction in the numbers of deaths in burn cases, in third world countries these numbers still very high. Even thou burns are a very frequent problem in Brazil, there are few studies and even fewer epidemiological data available. To describe the epidemiology and identify epidemiological variables and clinics that influence in the prognostic of adult burn patients. Observational, prospective study and series of adult burn cases, of which all are of 18 years of age or above, admitted in the Burn Care Unit of a tertiary referral University Hospital, in the central-west region of the state of São Paulo, southeast Brazil, that treats exclusively public health system, from May of 2006 to July of 2007. From the patients file and physical examination the following data has been extracted: sex, age, characteristics of the burn (cause, agent, extension and depth), time between the time of the burn and the admittance into the hospital, presence of inhalation injury, complications and duration of the hospital stay. The endpoint was considered release from the hospital or death. A comparison was made between the groups according to the endpoint, variables being quantized analyzed by the t Student and Wilcoxon tests or median by independent sampling, depending of the normality of the data and qualities variables by which were shown differences in the test. Considering the endpoint with a variable answer, the formula was readjusted by logistical regression due to the variable clinics. For the lenght stay there were calculated the survival curves by the Kaplan-Meier method, considering the endpoint as a censorship variable of all the patients, stratified by age, inhalation injury, depth, agent, cause and extension of the burn. In cases of curves obtained by stratification there was applied... (Complete abstract click electronic access below)
Differently from developed countries in which there have been a reduction in the numbers of deaths in burn cases, in third world countries these numbers still very high. Even thou burns are a very frequent problem in Brazil, there are few studies and even fewer epidemiological data available. To describe the epidemiology and identify epidemiological variables and clinics that influence in the prognostic of adult burn patients. Observational, prospective study and series of adult burn cases, of which all are of 18 years of age or above, admitted in the Burn Care Unit of a tertiary referral University Hospital, in the central-west region of the state of São Paulo, southeast Brazil, that treats exclusively public health system, from May of 2006 to July of 2007. From the patients file and physical examination the following data has been extracted: sex, age, characteristics of the burn (cause, agent, extension and depth), time between the time of the burn and the admittance into the hospital, presence of inhalation injury, complications and duration of the hospital stay. The endpoint was considered release from the hospital or death. A comparison was made between the groups according to the endpoint, variables being quantized analyzed by the t Student and Wilcoxon tests or median by independent sampling, depending of the normality of the data and qualities variables by which were shown differences in the test. Considering the endpoint with a variable answer, the formula was readjusted by logistical regression due to the variable clinics. For the lenght stay there were calculated the survival curves by the Kaplan-Meier method, considering the endpoint as a censorship variable of all the patients, stratified by age, inhalation injury, depth, agent, cause and extension of the burn. In cases of curves obtained by stratification there was applied... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Queimaduras - Prognóstico, Queimaduras - Tratamento, Fisiopatologia, Epidemiology, Prediction os mortality, Burns
Como citar
ROSA, Deborah Maciel Cavalcanti. Epidemiologia, lesão inalatória e biomarcadores: relação com prognóstico de adultos queimados internados em uma unidade de referência. 2009. 153 f. +. Tese (doutorado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2009.