Impacto da Fragilidade no pós operatório de pacientes submetidos a cirurgia cardíaca: uma revisão de escopo.
Data
2020-12-18
Autores
Justino, Natalia Dala 
Orientadores
Moreira, Rita Simone Lopes
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A cirurgia cardíaca engloba um público de várias faixas etárias, com comorbidades associadas, que possuem alto grau de fragilidade. Em 2017 as estatísticas da Organização Mundial de Saúde confirmam que a doença cardíaca (DC) continua a ser a principal causa de morte em todo o mundo. São intervenções complexas e requerem um tratamento específico em todas fases operatórias. Como os estudos ainda são escassos há uma necessidade de investigar melhor, a fragilidade no contexto do cuidado de pacientes de pós-operatório. Objetivos: Investigar na literatura, o impacto da fragilidade no contexto de pacientes de pós-operatório da cirurgia cardíaca convencional para sintetizar evidências científicas. Em segunda instância, busca identificar as escalas mais utilizadas na mensuração da mesma, visando identificar suas sequelas comportamentais no pós operatório. Métodos: Um estudo de revisão de literatura do tipo Revisão de Escopo, com busca nas bases de dados Lilacs, Pubmed e Cinahl, publicados em inglês, português e espanhol, realizada até novembro de 2020, segundo a metodologia do Joanna Briggs Institute (JBI; 2020)15 Resultados: Foram encontrados 1411 artigos na busca inicial, restando apenas 13 artigos que avaliaram fragilidade na cirurgia cardíaca convencional, todos publicados em língua inglesa. Dos 13 artigos deste estudo, foram identificados 03 estudos que demonstraram um aumento desse indicador em 30 dias, e 06 estudos mostram um aumento significativo em até 1 ano. Não houve homogeneidade entre escalas para o aspecto de mensuração deste fenômeno. Conclusão: Esta revisão afirma que a fragilidade é um preditor do aumento do índice de mortalidade, em pacientes submetidos à cirurgia cardíaca, com maior índice em paciente frágil comparado a pacientes não frágil. Concluiu-se que ainda não existem estudos homogêneos que definam a melhor escala de avaliação desta fragilidade, bem como a sua influência em pacientes de idade menor 75 anos, evidenciando assim, a necessidade da produção de mais estudos.
Introduction: Cardiac surgery involves patients of various age groups, with associated comorbidities, which have a high degree of frailty. In 2017, statistics showed by the World Health Organization confirm that heart disease remains the leading cause of death worldwide. Cardiac surgery is a complex intervention and requires specific treatment in all operative phases. As studies are still scarce, there is a need to further investigate about frailty in the context of post-operative patient care. Aim: To investigate in the literature, the impact of frailty in the context of patients in the postoperative period of conventional cardiac surgery to synthesize scientific evidence. In the second instance, it seeks to identify the most used scales for frailty measurement, aiming to identify its behavioral sequelae in the postoperative period. Methods: A literature review study, using the Joanna Briggs Institute scoping review methodology on the following databases: Lilacs, PubMed and Cinahl, English, Portuguese and Spanish Articles conducted from ANO until November 2020 were included. Results: 1411 studies were found in the initial search. 12 articles evaluated frailty in conventional cardiac surgery, all published in English. From them, 03 articles demonstrate an increase in 30-day mortality, and 06 studies showed a significant increase in up to 1 year. It was concluded that there are still no homogeneous studies that define the best scale for assessing frailty, as well as its influence on patients under 75 years of age. Conclusion: The studies retrieved in this review identified that frailty is a predictor of increased mortality rates in patients undergoing cardiac surgery, with a higher rate in a frail patient compared to non-frail patients. There was no homogeneity between scales for the measurement of this phenomenon, thus evidencing the need for further studies.
Introduction: Cardiac surgery involves patients of various age groups, with associated comorbidities, which have a high degree of frailty. In 2017, statistics showed by the World Health Organization confirm that heart disease remains the leading cause of death worldwide. Cardiac surgery is a complex intervention and requires specific treatment in all operative phases. As studies are still scarce, there is a need to further investigate about frailty in the context of post-operative patient care. Aim: To investigate in the literature, the impact of frailty in the context of patients in the postoperative period of conventional cardiac surgery to synthesize scientific evidence. In the second instance, it seeks to identify the most used scales for frailty measurement, aiming to identify its behavioral sequelae in the postoperative period. Methods: A literature review study, using the Joanna Briggs Institute scoping review methodology on the following databases: Lilacs, PubMed and Cinahl, English, Portuguese and Spanish Articles conducted from ANO until November 2020 were included. Results: 1411 studies were found in the initial search. 12 articles evaluated frailty in conventional cardiac surgery, all published in English. From them, 03 articles demonstrate an increase in 30-day mortality, and 06 studies showed a significant increase in up to 1 year. It was concluded that there are still no homogeneous studies that define the best scale for assessing frailty, as well as its influence on patients under 75 years of age. Conclusion: The studies retrieved in this review identified that frailty is a predictor of increased mortality rates in patients undergoing cardiac surgery, with a higher rate in a frail patient compared to non-frail patients. There was no homogeneity between scales for the measurement of this phenomenon, thus evidencing the need for further studies.
Descrição
Citação
JUSTINO, Natalia Dala. Impacto da Fragilidade no pós operatório de pacientes submetidos à cirurgia cardíaca: uma revisão de escopo. 57f. 2020. Dissertação (Mestrado) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2020.