Influência da atividade física prévia na mortalidade hospitalar de pacientes com choque séptico
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Data
2022-12-21
Autores
Ventrella, Amanda
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: A sepse é a resposta inadequada do organismo a uma infecção que gera redução da perfusão tecidual e falência orgânica caracterizando o choque séptico (CS). No CS ocorre o comprometimento dos sistemas pró e anti-inflamatórios, agravando ainda mais o quadro de infecção. Logo, é importante intervenções que modulem a resposta inflamatória tal como a atividade física. No entanto, a prática de atividade física (AF) previamente à ocorrência do choque séptico ainda não foi estudada. Objetivo: Avaliar a influência da atividade física (AF) antes do choque séptico na mortalidade intra-hospitalar desses pacientes. Métodos: Foram incluídos indivíduos acima de 18 anos de ambos os sexos que internaram com diagnóstico de choque séptico na Sala de Emergência do Hospital das Clínicas da Faculdade de Medicina de Botucatu. O grau de atividade física antes do choque séptico foi avaliado por um questionário aplicado aos familiares dos pacientes e a classificação da capacidade funcional foi realizada pelos equivalentes metabólicos (METs). As associações entre a atividade física e a mortalidade intra-hospitalar foram calculadas por regressão logística uni e multivariada. O nível de significância adotado foi de 5%. Resultados: Foram avaliados 46 pacientes com choque séptico, sendo que 67,4% eram do sexo masculino, com idade média de 62,4 ± 13,0 anos. Da amostra total, a mediana do METs foi 1,5 (1,0 - 2,3), sendo que 80,4% apresentaram METs < 4. A mediana do tempo de internação foi de 13,0 (4,8 - 28,5) dias e a mortalidade intra-hospitalar de 73,9%. O METs < 4 foi associado com maior mortalidade intra-hospitalar mesmo ajustado por sexo, idade, PCR e SOFA (OR: 7,039; IC95%: 1,060-46,727; p=0,043), e pelos glóbulos brancos (OR: 7,769; IC95%: 1,274-47,394; p=0,026). Conclusão: Em pacientes com choque séptico, o menor nível de atividade física junto a baixa capacidade funcional avaliada pelo METs < 4, foi associado com maior mortalidade intra-hospitalar.
Introduction: Sepsis is the body’s inadequate response to an infection that causes reduced tissue perfusion and organ failure, characterizing septic shock (SC). In CS, the pro- and anti-inflammatory systems are compromised, further aggravating the infection, therefore, interventions that modulate the inflammatory response, such as physical activity, are important. However, the practice of physical activity (PA) prior to the occurrence of septic shock has not yet been studied. Objective: To evaluate the influence of physical activity (PA) before septic shock on the in-hospital mortality of these patients. Methods: Individuals over 18 years of age of both genders who were hospitalized with a diagnosis of septic shock in the Emergency Room of the Hospital das Clínicas da Faculdade de Medicina de Botucatu were included. The degree of physical activity before septic shock was assessed using a questionnaire applied to patients' family members, and functional capacity was classified using metabolic equivalents (METs). Associations between physical activity and in-hospital mortality were calculated by univariate and multivariate logistic regression. The significance level adopted was 5%. Results: Forty-six patients with septic shock were evaluated, 67.4% of whom were male, with a mean age of 62.4 ± 13.0 years. Of the total sample, the median METs was 1.5 (1.0-2.3), with 80.4% having METs <4. The median length of stay was 13.0 (4.8- 28.5) days and the in-hospital mortality was 73.9%. METs < 4 was associated with higher in-hospital mortality even when adjusted for gender, age, CRP and SOFA (OR: 7.039; 95%CI: 1.060-46.727; p=0.043), and white blood cells (OR: 7.769; 95%CI : 1.274-47.394; p=0.026). Conclusion: In patients with septic shock, the lowest level of physical activity together with low functional capacity assessed by METs < 4, was associated with higher inhospital mortality
Introduction: Sepsis is the body’s inadequate response to an infection that causes reduced tissue perfusion and organ failure, characterizing septic shock (SC). In CS, the pro- and anti-inflammatory systems are compromised, further aggravating the infection, therefore, interventions that modulate the inflammatory response, such as physical activity, are important. However, the practice of physical activity (PA) prior to the occurrence of septic shock has not yet been studied. Objective: To evaluate the influence of physical activity (PA) before septic shock on the in-hospital mortality of these patients. Methods: Individuals over 18 years of age of both genders who were hospitalized with a diagnosis of septic shock in the Emergency Room of the Hospital das Clínicas da Faculdade de Medicina de Botucatu were included. The degree of physical activity before septic shock was assessed using a questionnaire applied to patients' family members, and functional capacity was classified using metabolic equivalents (METs). Associations between physical activity and in-hospital mortality were calculated by univariate and multivariate logistic regression. The significance level adopted was 5%. Results: Forty-six patients with septic shock were evaluated, 67.4% of whom were male, with a mean age of 62.4 ± 13.0 years. Of the total sample, the median METs was 1.5 (1.0-2.3), with 80.4% having METs <4. The median length of stay was 13.0 (4.8- 28.5) days and the in-hospital mortality was 73.9%. METs < 4 was associated with higher in-hospital mortality even when adjusted for gender, age, CRP and SOFA (OR: 7.039; 95%CI: 1.060-46.727; p=0.043), and white blood cells (OR: 7.769; 95%CI : 1.274-47.394; p=0.026). Conclusion: In patients with septic shock, the lowest level of physical activity together with low functional capacity assessed by METs < 4, was associated with higher inhospital mortality
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Palavras-chave
Choque séptico, Exercício físico, Atividade física, Equivalentes metabólicos, Septic shock, Physical exercise, Physical activity, Sepsis, Basal metabolic rate