Baixa mobilidade nas primeiras 24 horas de admissão correlaciona-se a piores desfechos clínicos em pacientes com COVID-19 na UTI: um estudo transversal
Low mobility in the first 24 hours of admission correlates with worse clinical outcomes in COVID-19 patients in the ICU: a cross-sectional study
Darlisson Bueno Paranhos, Raquel Annoni, Luciane Fernanda Rodrigues Martinho Fernandes
Resumo
Introdução: Pacientes com COVID-19 internados em unidades de terapia intensiva (UTI) apresentam níveis reduzidos de mobilidade no momento da admissão. Contudo, a correlação entre o maior nível de mobilidade nas primeiras 24 horas de admissão com desfechos clínicos na UTI ainda é incerto. Objetivo: Investigar a correlação entre o nível de mobilidade nas primeiras 24 horas de admissão na UTI, escore APACHE II, tempo de VM, período de internação na UTI, tempo de internação pós-UTI e a duração total da hospitalização em pacientes com COVID-19 internados em UTI. Métodos: Estudo transversal realizado em uma UTI destinada a pacientes adultos com COVID-19. Foram coletados dos prontuários dados sociodemográficos e clínicos. O nível e mobilidade nas primeiras 24 horas de internação na UTI foi avaliado pelo ICU Mobility Scale (IMS). A correlação entre o nível de mobilidade nas primeiras 24 horas de admissão na UTI e desfechos clínicos foi testada através do teste de Spearman. Resultados: Foram incluídos 192 pacientes. Nas primeiras 24 horas de admissão na UTI, 53,1% dos pacientes apresentaram nenhuma ou mínima atividade, enquanto apenas 3,6% atingiram alta intensidade de mobilidade. O maior nível de mobilidade se correlacionou significativamente com APACHE II (r = -0,369; p < 0,001) e tempo de internação após a alta da UTI (r = -0,361; p = 0,004). Conclusão: Pacientes que apresentam baixo nível de mobilidade nas primeiras 24 horas na UTI estão relacionados a maior gravidade e maior tempo de permanência após UTI.
Palavras-chave
Abstract
Background: COVID-19 patients admitted to intensive care units (ICUs) exhibit reduced mobility levels at the time of admission. However, the correlation between the highest mobility level within the first 24 hours of ICU admission and clinical outcomes in the ICU remains uncertain. Aim: To investigate the correlation between the level of mobility within the first 24 hours of ICU admission, APACHE II score, mechanical ventilation (MV) duration, ICU length of stay, post-ICU hospitalization time, and total hospital stay in COVID-19 patients admitted to the ICU. Methods: A cross-sectional study was conducted in an ICU for adult COVID-19 patients. Sociodemographic and clinical data were collected from medical records. The level of mobility during the first 24 hours of ICU admission was assessed using the ICU Mobility Scale (IMS). The correlation between the level mobility within the first 24 hours of ICU admission and clinical outcomes was tested using Spearman’s test. Results: A total of 192 patients were included. Within the first 24 hours of ICU admission, 53,1% of patients exhibited no or minimal activity, while only 3,6% achieved high-intensity mobility. The highest level of mobility was significantly correlated with APACHE II (r= -0,369; p< 0,001) and post- ICU hospitalization time (r = -0,361; p= 0,004). Conclusion: Patients with low mobility levels within the first 24 hours in the ICU are associated with greater severity and longer post-ICU hospitalization times.
DOI da versão traduzida: https://doi.org/10.47066/2966-4837.2024.0010en
Keywords
Referências
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Submetido em:
15/01/2025
Aceito em:
13/03/2025
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