Ocorrência de úlcera por pressão em pacientes com lesão medular em um hospital público de Maceió
Data
2011
Autores
Costa, Rosimeyre Correia 
Orientadores
Gamba, Mônica Antar
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
O traumatismo da coluna vertebral com lesão irreversível da medula e um dos agravos mais temíveis que altera drasticamente a qualidade de vida do indivíduo, grande proporção dos acometidos desenvolve ulceras por pressão. Objetivo: Identificar os fatores associados a ocorrência de lesão medular e ulcera por pressão em pessoas hospitalizadas em um hospital público de Maceió segundo variáveis sociodemograficas e clinicas. Método: Estudo transversal, realizado no Hospital Geral Público Maceió-AL. Após aprovação do comitê de ética e pesquisa foram analisados 232 prontuários que atenderam os critérios de inclusão: LME traumática, hospitalizadas de janeiro 2008 a dezembro 2009, independente da faixa etária e sexo. Resultados: A maioria dos investigados (88,4%) e do sexo masculino, (26.7%) com idade entre 30 e 44 anos. A causa mais frequente da LME traumática (27,2%) foi FAF seguindo por (25,4%) quedas, destes 41,4% ficaram paraplégicos e 15,5% tetraplégicos. O tempo médio de internação foi de 20,9 dias (desvio-padrão=37,10), o tratamento pôs-trauma (68,1%) foi conservador, porem (29,3%) dos lesados necessitar de intervenção cirúrgica. Destes (12,5%) evoluíram a óbito por complicações do trauma ou por problemas com as UP. A prevalência (35,3%) de ulceras por pressão nos lesados medulares hospitalizados e alta. E as pessoas com LME, que desenvolveram mais ulceras por pressão residem na capital Maceió, provenientes de áreas distritais periféricas. As variáveis associadas a ocorrência de UP em LME traumática foram o tratamento cirúrgico pôs-trauma (OR= 12,81; IC 95%: 2,56 a 64,19 p = 0,002), o tempo de internação superior a 10 dias (OR ajust = 5,09; IC 95%:1,21 a 21,34; p=0,026) e os pacientes que utilizam como referência os distritos sanitários I, II e III (OR= 6,6; IC95%:1,23 a 35,99 p=0,028). As variáveis associadas a ocorrência da UP apontam para a necessidade da implementação de ações de prevenção e controle das ulceras por pressão em lesados medulares na instituição.
Traumatic spinal cord injury with irreversible bone marrow is one of the most dreaded diseases that drastically alter the quality of life in the individuals, a large proportion in the patients affected developing pressure ulcers. Objective: To identify factors associated with spinal cord injury and pressure ulcer in hospitalized people in a public hospital in Maceió the according to sociodemographic variables and clinical. Methods: Cross-sectional study conducted at Hospital General Public Maceió-Al. After approval of the ethics committee and research analyzed 232 records that were in the inclusion criteria: LME traumatic hospitalized from January 2008 to December 2009, independently of age and gender. Results: The majority of those investigated (88.4%) is male (26.7%) aged between 30 and 44 years. The most frequent cause of traumatic SCI (27.2%) was followed by FAF (25.4%) falls, despite 41.4% became paraplegic and 15.5% became quadriplegic. The average length in the hospital was 20.9 days (SD = 37.10), the post-trauma treatment (68.1%) was conservative, however (29.3%) of victims require surgery. These (12.5%) died from complications of trauma or problems with the UP. The prevalence (35.3%) of pressure ulcers in spinal cord injured in patients is high. People with SCI who developed pressure ulcers live in the capital of Maceió from areas outlying district. Variables associated with the occurrence of PU in SCI were traumatic surgical treatment after trauma (OR = 12.81, 95% CI: 2.56 to 64.19 p =0.002), length in the hospital exceeding 10 days (OR adjust = 5.09, 95% CI: 1.21 to 21.34, p = 0.026) and patients who use as reference the health districts I, II and III (OR = 6.6, 95% CI: 1.23 to 35.99 p = 0.028).The variables associated with the occurrence of PU emphasizes the need to implement prevention and control of pressure ulcers in spinal cord injury in the institution.
Traumatic spinal cord injury with irreversible bone marrow is one of the most dreaded diseases that drastically alter the quality of life in the individuals, a large proportion in the patients affected developing pressure ulcers. Objective: To identify factors associated with spinal cord injury and pressure ulcer in hospitalized people in a public hospital in Maceió the according to sociodemographic variables and clinical. Methods: Cross-sectional study conducted at Hospital General Public Maceió-Al. After approval of the ethics committee and research analyzed 232 records that were in the inclusion criteria: LME traumatic hospitalized from January 2008 to December 2009, independently of age and gender. Results: The majority of those investigated (88.4%) is male (26.7%) aged between 30 and 44 years. The most frequent cause of traumatic SCI (27.2%) was followed by FAF (25.4%) falls, despite 41.4% became paraplegic and 15.5% became quadriplegic. The average length in the hospital was 20.9 days (SD = 37.10), the post-trauma treatment (68.1%) was conservative, however (29.3%) of victims require surgery. These (12.5%) died from complications of trauma or problems with the UP. The prevalence (35.3%) of pressure ulcers in spinal cord injured in patients is high. People with SCI who developed pressure ulcers live in the capital of Maceió from areas outlying district. Variables associated with the occurrence of PU in SCI were traumatic surgical treatment after trauma (OR = 12.81, 95% CI: 2.56 to 64.19 p =0.002), length in the hospital exceeding 10 days (OR adjust = 5.09, 95% CI: 1.21 to 21.34, p = 0.026) and patients who use as reference the health districts I, II and III (OR = 6.6, 95% CI: 1.23 to 35.99 p = 0.028).The variables associated with the occurrence of PU emphasizes the need to implement prevention and control of pressure ulcers in spinal cord injury in the institution.
Descrição
Citação
COSTA, Rosimeyre Correia. Ocorrência de úlcera por pressão em pacientes com lesão medular em um hospital público de Maceió. 2011. 88 f. Dissertação (Mestrado) -Universidade Federal de São Paulo, São Paulo, 2011.