Impacto e caracterização clínica da diarreia em Cuidados Intensivos - Estudo retrospectivo The impact and characterisation of clinical diarrhoea in Intensive Care Units - A retrospective study

Objective: To evaluate the impact and clinically characterise patients who developed diarrhoea in an Intensive Care Unit (ICU). Design: A 1-year (2004) retrospective, case-control study. Methods: patients with an ICU stay longer than 24 hours and with enteric tube feeding, were included. Diarrhoea was defined as 3 or more loose watery stools during a 24-hour period. Patients with colectomy or ileostomy were excluded. From a total of 461 patients admitted, 140 met the inclusion criteria; of these, 52 developed diarrhoea. For clinical characterisation the following parameters were evaluated: age, gender, ICU stay, severity scores (APACHE II and SAPS II), therapy with antibiotics, serum urea and creatinine, haemoglobin (Hg), serum proteins, co-morbilities and ICU mortality. Patients with and without diarrhoea were compared regarding the above parameters. Comparison was performed with student t- test; correlation between numerical variables was performed with linear regression analysis; logistic regression analysis was performed to identify independent predictive parameters for mortality in patients with diarrhoea. Results: Patients with diarrhoea had lower Hg (p=0,007), higher serum urea (p=0,014) and higher mortality (p<0,001). Deceased patients with diarrhoea presented a lower Hg (p=0,001) and a higher serum urea (p=0,0014) and creatinine (p=0,03). Hg was independently related to mortality in patients with diarrhoea