Análise comparativa das escalas de sedação de Ramsay e Richmond para a avaliação da mortalidade em pacientes internados em UTI Título em Inglês

Abstract

Our study main goal was to determine if there is similarity of the Ramsay e Richmond sedation scales, as well as the association between their scores and mortality rates in critical ICU patients. Methods: Mechanical ventilation parameters and modes, sedation modality and dose, Ramsay and Richmond sedation levels scores, Acute Physiological and Chronic Heatlh Evaluation II (APACHE II), mean arterial pressure (MAP), heart and respiratory rates (HR, RR), hospital and mechanical ventilation length of stay and mortality rate was assessed. Results: Our patients presented mean age of 57.6±15.2 years and mean hospital length of stay of 9.0±7.35. Continuous sedation was delivered for most patients and their Ramsay, Richmond and APACHE II scores were elevated; up to 42.85% survived thourout hospital admission to discharge. Our data showed increased Ramsay (p=0.006) and Richmond (p=0.01) sedation scores in the death subgroup. The sedation methods used in our study showed to be highly similar; both also presented increased sensibility and specificity to screen death in sedated patients (Ratio=0.81, CI95%= 0.65 to 0.97, p=0.004; Ratio=0.79, IC95%= 0.64 to 0.96, p=0.007, respectively). Moreover, we found a mortality chance up to 3.75 and 4 times higher when patients were sedated up to -5 and 6 scores at the Richmond e Ramsay scales, respectively. Conclusion: We conclude that Ramsay e Richmond sedation scales are similar and that deep continuous sedation increases mortality rate in ICU patients.