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Master's Dissertation
DOI
https://doi.org/10.11606/D.7.2019.tde-22072019-155002
Document
Author
Full name
Sara de Oliveira Xavier
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2018
Supervisor
Committee
Ferretti-Rebustini, Renata Eloah de Lucena (President)
Cruz, Dina de Almeida Lopes Monteiro da
Moreira, Rita Simone Lopes
Santos, Eduarda Ribeiro dos
Title in Portuguese
Características clínicas da insuficiência cardíaca associadas à dependência funcional admissional em idosos hospitalizados
Keywords in Portuguese
Atividades Básicas de Vida Diária
Dependência
Enfermagem
Hospitalização
Idoso
Insuficiência Cardíaca
Abstract in Portuguese
Introdução: O cenário da Insuficiência Cardíaca (IC) em pacientes idosos hospitalizados é complexo e influenciado pela presença de características clínicas que representam alto risco para dependência funcional (DF) nas Atividades Básicas de Vida Diária (AbVDs). Estudo anterior evidenciou que a IC está associada à maior dependência admissional em idosos hospitalizados, no entanto, não se sabe ao certo qual componente clínico da IC está associado com a maior dependência nesses pacientes. Objetivo: Identificar quais características clínicas da IC estão associadas à maior chance de DF admissional para as AbVDs em idosos hospitalizados. Método: Estudo transversal, realizado com idosos internados em um Hospital de referência em cardiologia de São Paulo SP. As características clínicas da IC foram avaliadas por meio do relato do paciente, do registro em prontuário e por meio da aplicação de escalas. A DF para AbVDs foi avaliada através do Índice de Katz. Os dados foram analisados por meio de testes de associação e comparação de médias. A análise de regressão logística multivariada foi utilizada para verificar quais características clínicas da IC estão associadas à DF admissional. Resultados: A amostra foi composta por 191 casos. A prevalência de DF à admissão hospitalar em idosos com IC foi de 70,2%. A maior parte dos idosos era parcialmente dependente (66,6%) à admissão. As características clínicas associadas à DF admissional foram: dispneia (OR 8,5; IC95% 2,668-27,664; p<0,001), edema de membros inferiores (OR 5,7; IC95% 2,148-15,571; p<0,001); tosse (OR 9,0; IC95% 1,053-76,938; p<0,045); precordialgia (OR 4,5; IC95% 1,125-18,023; p<0,033) e crepitação pulmonar (OR 4,9; IC95% 1,704-14,094; p<0,003). Conclusões: Observou-se que a DF admissional em idosos com IC está mais associada com sinais e sintomas congestivos. Compreender e avaliar corretamente cada sinal e sintoma provoca um impacto positivo, na medida em que estratégias preventivas de perda funcional podem ser aplicadas em idosos com IC.
Title in English
Clinical characteristics of heart failure associated with functional admission in hospitalized elderly patients.
Keywords in English
Activities of daily living
Dependence
Elderly
Heart Failure
Hospitalization
Nursing
Abstract in English
Introduction: The scenario of Heart Failure (HF) in hospitalized elderly patients is complex and influenced by the presence of clinical characteristics that represent a high risk for functional dependence (FD) in Activities of daily living (ADL). A previous study analyzed the association between heart failure and functional dependence, however, which clinical characteristics of HF is associated with FD were not reported. Purpose: To identify the clinical characteristics of FD associated with FD at admission in hospitalized elderly patients. Method: A cross-sectional study investigated elderlies admitted at cardiology hospital in São Paulo - SP. The clinical characteristics of HF were evaluated through self-report, medical record and scales. DF for AbVDs was assessed using the Katz Index. Data were analyzed by association tests and comparison of means. Multivariate logistic regression analysis was used to verify which clinical characteristics of HF are associated with admission FD. Results: The sample consisted of 191 cases. The prevalence of admission FD in the elderly with HF was 70,2%. The majority of elderlies was partially dependent (66,6%) on admission. The clinical characteristics associated to the admission DF were: dyspnea (OR 8,5; IC95% 2,668-27,664; p<0,001), edema (OR 5,7; IC95% 2,148-15,571; p<0,001); cough (OR 9,0; IC95% 1,053- 76,938; p<0,045); chest pain (OR 4,5; IC95% 1,125-18,023; p<0,033) e pulmonary crackles (OR 4,9; IC95% 1,704-14,094; p<0,003). Conclusions: The Admission FD in elderly with HF is more associated with congestive signs and symptoms. Understanding and correctly assessing each sign and symptom has a positive impact, insofar as functional loss prevention strategies can be applied in the elderly patients with HF.
 
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Publishing Date
2019-12-03
 
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