Performance de trigger tools para triagem de potencial delirium hiperativo em pessoas idosas hospitalizados em departamento de emergência brasileiro

Júlia  RASO; Lincoln M.  SANTOS; Débora A.  REIS; Marília A.  FRANGIOTTI; Ariane C.  ZANETTI; Helaine C.  CAPUCHO; Maria T.  HERDEIRO; Fátima  ROQUE; Leonardo R.  LEIRA-PEREIRA; Fabiana R.  VARALLO

doi:10.30968/rbfhss.2022.134.0874

Autores

Júlia RASO https://orcid.org/0000-0001-5479-6719
Lincoln M. SANTOS https://orcid.org/0000-0001-5102-1766
Débora A. REIS https://orcid.org/0000-0002-9433-7936
Marília A. FRANGIOTTI https://orcid.org/0000-0002-2376-0163
Ariane C. ZANETTI https://orcid.org/0000-0002-4458-3274
Helaine C. CAPUCHO https://orcid.org/0000-0002-5438-7963
Maria T. HERDEIRO https://orcid.org/0000-0002-0500-4049
Fátima ROQUE https://orcid.org/0000-0003-0169-3788
Leonardo R. LEIRA-PEREIRA https://orcid.org/0000-0002-8609-1390
Fabiana R. VARALLO https://orcid.org/0000-0003-4016-1442

DOI:

https://doi.org/10.30968/rbfhss.2022.134.0874

Resumo

Objetivo: Avaliar o desempenho de termos trigger tools na detecção de internações de pacientes idosos com potencial delirium hiperativo em uma unidade de emergência. Métodos: Um estudo transversal foi realizado com todos os pacientes com idade ≥ 60 anos internados em unidade de emergência de um hospital universitário brasileiro em 2018. A triagem de potencial delirium hiperativo foi feita com as seguintes trigger tools: prescrição instra-hospitalar de antipsicóticos, códigos do 10° Código Internacional de Doenças (CID-10) proposto pela 5ª edição do Manual Diagnóstico e Estatístico de Transtornos Mentais, e palavras-chave relacionadas com delirium hiperativo registradas em prontuários médicos por profissionais da saúde. O valor preditivo positivo (VPP) foi calculado para avaliar a performance de cada trigger tool. Resultados: A maioria das hospitalizações (192/286) foi triada por pelo menos um dos trigger tools, das quais 49.2% mostrou potencial delirium hiperativo. O trigger tool de CID-10 mostrou uma melhor performance (VPP=0.71), no entanto, essa estratégia subestimou a detecção de casos potenciais [2.6% (5/193)]. A despeito da performance de das prescrições intra-hospitalares de antipsicóticos e palavras-chave ter sido mais baixa (VPP=0.69, e VPP=0.48, respectivamente), a prevalência de potencial delirium hiperativo identificado foi maior com estes métodos [30.0% (58/193); e 47.1% (91/193); respectivamente]. Conclusão: O uso de trigger tools detectou uma a cada três hospitalizações de idosos com potencial delirium hiperativo. A combinação das estratégias pode contribuir para o reconhecimento da síndrome em unidade de emergência. Os dados sugerem que a triagem pode ser realizada por farmacêuticos em associação com abordagens multicomponentes e interprofissionais para melhorar a segurança do paciente.

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