Fatores associados à readmissão hospitalar precoce de pacientes internados por descompensação aguda da cirrose – Estudo de coorte prospectivo
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Introdução: Os primeiros meses após a internação do paciente cirrótico são considerados de alto risco para novas complicações. Conhecer os fatores associados à reinternação precoce nesses indivíduos pode contribuir para o desenvolvimento de estratégias preventivas que evitem os riscos e custos relacionados a uma nova internação. Objetivo: Investigar os fatores associados à reinternação precoce de pacientes internados por descompensação aguda da cirrose. Métodos: Foram considerados os dados da primeira internação de cada paciente durante o período do estudo e acompanhados até o 90º dia por contato telefônico. Estudo de coorte prospectivo no sul do Brasil. Resultados: Entre 2011 e 2016, 280 pacientes foram incluídos no estudo. A média de idade foi de 55,68±11,21 anos, sendo 71,8% do sexo masculino com MELD médio de 15,65±5,64 e 41,4% Child-Pugh C. A reinternação precoce ocorreu em 91 casos (32,5%). Na análise de regressão logística, as variáveis CLIF-SOFA (odds ratio [OR] 1,137, intervalo de confiança [IC] 95% 1,003–1,289, p=0,045) e número de complicações presentes na hospitalização inicial (OR 1,503, IC 95% 1,074 –2,105, p=0,018) independente da readmissão precoce. As taxas de readmissão precoce foram de 16,8% em pacientes com CLIF-SOFA <8 e menos de 2 complicações na admissão e 49,2% naqueles com CLIF-SOFA ≥8 e 2 ou mais complicações na internação inicial. Conclusão: Parâmetros simples como o CLIF-SOFA e o número de complicações da cirrose presentes na admissão hospitalar são preditores de reinternação precoce e podem ser usados como ferramentas para individualizar o acompanhamento de pacientes cirróticos após a alta hospitalar.
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