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Complicações de cuidados no internamento por diabetes mellitus tipo 2: a situação das infeções urinárias
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Advisor(s)
Abstract(s)
Objetivo: O objetivo primário consistiu em estudar a prevalência da taxa das infeções
urinárias durante o internamento; e o objetivo secundário: identificar os fatores
explicativos para estas infeções.
Métodos: Estudo transversal com recolha de dados retrospetivos no período de 01
janeiro a 31 de dezembro de 2015. Utilizou-se a base de dados dos resumos de alta
para os episódios de internamento da Diabetes mellitus tipo 2 (DMTII), como diagnóstico
principal. Na primeira abordagem usou-se a análise estatística descritiva bivariável onde
se calculou a distribuição e a taxas das infeções urinárias. Na segunda abordagem
usou-se a regressão logística com recurso ao modelo de ajustamento pelo risco: as
infeções urinárias constituíram a variável dependente; o género, a idade, a gravidade
da doença principal, as co morbilidades e respetivos níveis de gravidade, o número de
dias de internamento, o hospital, o tipo de procedimento e os GDH, as variáveis
independentes.
Resultados: As taxas das Infeções Urinárias apresentaram um valor de 16,2%. Os
diabéticos de gravidade (1) apresentaram uma taxa de 24,4% contra 4,8% nos
diabéticos de gravidade (2). No tipo de tratamento médico a taxa foi de 24,6% contra 4,8% no tratamento cirúrgico. Os fatores de risco como a idade (OR=1,031), o número
de dias de internamento (OR=1,018), o género feminino (OR=2,248), a gravidade (3) da
co morbilidade Doença Cerebrovascular (NEU04) (OR=1,737), a gravidade (1) da co
morbilidade Neoplasia maligna do cólon e reto (GIS27) (OR=2,417), bem como dez
hospitais tiveram influência sobre a ocorrência de COC Urinárias.
Conclusões: Estes resultados podem ser justificados por práticas clínicas distintas e
pela adoção de protocolos de cuidados pouco seguros, pelo que é necessário
implementar uma vigilância dirigida e um reforço de prevenção e controlo através da
elaboração de modelos de segurança mais efetivos.
Abstract Context: The primary objective was to study the prevalence of the rate of urinary infections during hospitalization; and the secondary objective: to identify the risk factors for these infections. Methodology: A cross-sectional study with retrospective data collection from January 1st to December 31st, 2015. The database of the discharge summaries for the hospitalization episodes of Type 2 Diabetes Mellitus (DMTII) was used as the principal diagnosis. In the first approach we used the bivariate descriptive statistical analysis where the distribution and rates of urinary infections were calculated. The second approach used the logistic regression using the risk-adjustment model: the COC Urinary was the dependent variable; sex, age, the severity of the principal disease, the severity of the comorbidities, number of hospitalization days, hospital, type of procedure and GDH, were independent variables. Results: The principal results found indicate that the COC Urinary rate was of 16.2%. Diabetics of stage (1) the rate was 24.4% versus 4.8% in diabetics of stage (2). In the type of medical treatment, the rate was 24.6% versus 4.8% in the surgical treatment. The risk factors, such as age (OR=1.031), number of hospitalization days (OR=1.018), female gender (OR=2.248), the stage (3) of comorbidity Cerebrovascular disease (NEU04) (OR=1.737) and the stage (1) of comorbidity Malignant neoplasm of colon and rectum (GIS27) (OR=2.417), as well as ten hospitals had influence over the occurrence of COC Urinary. Conclusion: These results can be justified by different clinical practices and the adoption of unsafe care protocols. These findings lend support to the importance of implementing a targeted surveillance and development effective models of patient safe in COC.
Abstract Context: The primary objective was to study the prevalence of the rate of urinary infections during hospitalization; and the secondary objective: to identify the risk factors for these infections. Methodology: A cross-sectional study with retrospective data collection from January 1st to December 31st, 2015. The database of the discharge summaries for the hospitalization episodes of Type 2 Diabetes Mellitus (DMTII) was used as the principal diagnosis. In the first approach we used the bivariate descriptive statistical analysis where the distribution and rates of urinary infections were calculated. The second approach used the logistic regression using the risk-adjustment model: the COC Urinary was the dependent variable; sex, age, the severity of the principal disease, the severity of the comorbidities, number of hospitalization days, hospital, type of procedure and GDH, were independent variables. Results: The principal results found indicate that the COC Urinary rate was of 16.2%. Diabetics of stage (1) the rate was 24.4% versus 4.8% in diabetics of stage (2). In the type of medical treatment, the rate was 24.6% versus 4.8% in the surgical treatment. The risk factors, such as age (OR=1.031), number of hospitalization days (OR=1.018), female gender (OR=2.248), the stage (3) of comorbidity Cerebrovascular disease (NEU04) (OR=1.737) and the stage (1) of comorbidity Malignant neoplasm of colon and rectum (GIS27) (OR=2.417), as well as ten hospitals had influence over the occurrence of COC Urinary. Conclusion: These results can be justified by different clinical practices and the adoption of unsafe care protocols. These findings lend support to the importance of implementing a targeted surveillance and development effective models of patient safe in COC.
Description
Provas públicas apresentadas à Escola Superior de Saúde Dr. Lopes Dias do Instituto Politécnico de Castelo Branco para o cumprimento dos requisitos necessários à obtenção do título de Especialista.
Keywords
Diabetes mellitus tipo 2 Infeções urinárias Internamento Type 2 diabetes mellitus COC urinary In-hospital
Pedagogical Context
Citation
LOURENÇO, Maria Cristina Carrondo Afonso (2020) - Complicações de cuidados no internamento por diabetes mellitus tipo 2: a situação das infeções urinárias. IPCB, ESALD, 18 p.
Publisher
Instituto Politécnico de Castelo Branco, Escola Superior de Saúde Dr. Lopes Dias