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Objective: To compare the performance of the Simplified Acute Physiology Score 3 (SAPS 3) in patients with and without solid cancer who were admitted to the intensive care unit of a comprehensive oncological hospital in Brazil. Methods: We performed a retrospective cohort analysis of our administrative database of the first admission of adult patients to the intensive care unit from 2012 to 2016. The patients were categorized according to the presence of solid cancer. We evaluated discrimination using the area under the Receiver Operating Characteristic curve (AUROC) and calibration using the calibration belt approach. Results: We included 7,254 patients (41.5% had cancer, and 12.1% died during hospitalization). Oncological patients had higher hospital mortality than nononcological patients (14.1% versus 10.6%, respectively; p < 0.001). SAPS 3 discrimination was better for oncological patients (AUROC = 0.85) than for nononcological patients (AUROC = 0.79) (p < 0.001). After we applied the calibration belt in oncological patients, the SAPS 3 matched the average observed rates with a confidence level of 95%. In nononcological patients, the SAPS 3 overestimated mortality in those with a low-middle risk. Calibration was affected by the time period only for nononcological patients. Conclusion: SAPS 3 performed differently between oncological and nononcological patients in our single-center cohort, and variation over time (mainly calibration) was observed. This finding should be taken into account when evaluating severity-of-illness score performance. [ABSTRACT FROM AUTHOR]

Introduction: Hydrocephalus is a common complication among neurological patients whose treatment in acute cases is done through an external ventricular drain catheter which allows monitoring and controlling intracranial hypertension. This study aimed at describing the knowledge retention by nurses after an educational intervention on nursing care for an external ventricular drain. Materials and Methods: A quasi-experimental study with nurses at an adult intensive care unit was conducted in which knowledge retention on the topic was evaluated at different three times: before, one week and three months after training. Results: After one week, significant retention was observed but not after three months, given that after this period the question success rate was significantly low with respect to the previous phases. Participants' performance was better in those questions related to system management. Discussion: Time is a factor that interferes with learning since studies show that knowledge at three months significantly decreases and is almost completely gone after six months and a year. Practical behaviors based on assistance guidelines have better retention among professionals, underlining that it is easier to learn technical skills that are associated with professional experience. Conclusions: A significant knowledge retention was observed among professionals in the first week after training but not after three months. [ABSTRACT FROM AUTHOR]

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Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo: Identificar a associação entre incidentes ou eventos adversos (EA) na unidade de terapia intensiva (UTI) com internação hospitalar prolongada e os fatores de risco relacionados. Métodos: Estudo coorte, prospectivo. Pacientes admitidos na UTI com tempo de permanência mínimo de 24 horas, entre maio a novembro de 2016 foram avaliados. Tempo de internação hospitalar prolongada foi definido como maior de 14 dias. Dados epidemiológicos e variáveis relacionadas aos EA foram coletados. Resultados: Internaram na UTI 1172 pacientes, sendo incluídos 890 com idade média de 67,6 anos, 460 (51,7%) do sexo masculino, 564 (63,7%) internações clínicas, 107 (12,0%) readmissões e SAPS 3 mediano de 45,0. Os pacientes com internação hospitalar prolongada apresentaram mais frequentemente SAPS 3>50,0 (p<0,001), EA (p<0,001), idade superior a 80 anos (p=0,002) e diagnóstico de sepse (p<0,001). Os fatores de risco foram flebite (p=0,017; OR=2,9 [IC=1,2-7,0]), EA após 48 horas de internação na UTI (p=0,001; OR=2,6 [IC=1,5-4,4]), maior carga de trabalho médico (p=0,002, OR=1,9 [IC=1,3-2,9]) e mais dispositivos invasivos (p=0,001; OR=1,7 [IC=1,3-2,3]). Conclusão: Pacientes com internação hospitalar prolongada apresentaram maior morbidade e severidade e associação com incidentes ou EA na UTI. Os fatores de risco para internação hospitalar prolongada foram flebite, EA tardio, mais paciente por médico na unidade e uso de mais dispositivos invasivos. [ABSTRACT FROM AUTHOR]