CLARICE TANAKA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina - Líder
7 resultados
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conferenceObject Occurrence Of Systemic And Pulmonary Complications In Patients Undergoingtracheostomy(2013) RAMOS, M. C. S.; SILVA, J. M.; MAFRA, M.; SILVEIRA, L.; CARRASCOSA, T.; TANAKA, C.; FU, C.conferenceObject Functional status of patients readmitted to ICU(2013) SILVEIRA, Leda T. Y.; SILVA, Janete M.; MAFRA, Jose M. S.; RAMOS, Michele C. S.; TANAKA, Clarice; FU, Carolina- Decline in functional status after intensive care unit discharge is associated with ICU readmission: a prospective cohort study(2019) SILVEIRA, Leda Tomiko Yamada da; SILVA, Janete Maria da; TANAKA, Clarice; FU, CarolinaObjectives To compare the functional status at intensive care unit (ICU) discharge of patients who were later readmitted to the ICU and patients discharged home and to verify whether a decline in functional status is associated with ICU readmission. Design Prospective cohort study. Setting ICU at a tertiary teaching hospital. Participants Patients admitted to the ICU, >= 18 years old, submitted to invasive mechanical ventilation (IMV), and discharged to the ward. Interventions Functional assessment at ICU discharge. Discharge Group (DG) (patients discharged home) and Readmission Group (RG) (patients who returned to the ICU) were compared with Mann-Whitney and Chi-square or Exact Fisher tests. Multiple logistic regression verified association. Main outcome measures Barthel Index, key pinch strength, clinical and demographic data. Results Patients in the readmission group presented lower Barthel Index [Median 40 (IQR 20-75) vs 60 (33-83), P= 0.033], greater relative variation (pre and post ICU) of the Barthel Index (P = 0.04), lower key pinch strength [3.4 (1.8-4.5) vs 4.5 (2.7-6.8) kg.f, P = 0.006] and higher APACHE II [18 (12-22) vs 15 (11-20), P = 0.027]. Multiple regression found that the relative variation of the Barthel Index was independently associated with ICU readmission (P <0.001), as well as higher APACHE II (P=0.020), shorter IMV duration (P <0.001) and ICU admission without clear diagnosis (P= 0.020). The Hosmer-Lemeshow test indicated good adjustment of the model (P= 0.99). Conclusion Readmitted patients presented poorer functional status and lower pinch strength. Relative variation of the Barthel Index was associated with ICU readmission despite other factors, as was higher APACHE II, shorter IMV duration and admission without clear diagnosis.
conferenceObject Postoperative pulmonary complications are associated to higher ICU cost(2013) ROTTA, Bruna Peruzzo; SILVA, Janete Maria da; PADOVANI, Caue; SILVEIRA, Leda Tomiko Yamada da; MARCELO, Jose; FU, Carolina; TANAKA, ClariceconferenceObject Could Early Tracheostomy Reduce Costs In Intensive Care Unit?(2013) RAMOS, M. C. S.; SILVA, J. M.; ROTTA, B. P.; SILVEIRA, L. T. Y.; PADOVANI, C.; MAFRA, J. M. E. S.; CARRASCOSA, T. D.; TANAKA, C.; FU, C.conferenceObject Functional Capacity Of Burned Patients Immediately After Intensive Care Unit Discharge(2013) SILVA, J. M.; RAMOS, M. C. S.; ROTTA, B. P.; SILVEIRA, L. T. Y.; PADOVANI, C.; MAFRA, J. M. E. S.; FU, C.; TANAKA, C.- Assessing functional status after intensive care unit stay: the Barthel Index and the Katz Index(2018) SILVEIRA, Leda Tomiko Yamada Da; SILVA, Janete Maria Da; SOLER, Julia Maria Pavan; SUN, Carolina Yea Ling; TANAKA, Clarice; FU, CarolinaObjective: To assess the functional status of post-ICU patients using the Barthel Index (BI) and the Katz Index (KI) and to assess which is more suitable for this population. Design: Retrospective longitudinal study. Setting: Public tertiary hospital in Sao Paulo (Brazil). Participants: Patients aged >= 18 years old, admitted to ICU, who were treated with mechanical ventilation (MV) >= 24 h and were discharged to ward. Exclusion criteria: Inability to answer the BI and the KI; limiting neurological or orthopaedic conditions; ICU stay >= 90 days. Patients transferred to or from other hospitals or who died in the wards were not analysed. Intervention: BI and KI were scored pre-ICU and post-ICU and the variation was calculated. Main Outcome Measures: BI and KI scores were compared using analysis based on item response theory (IRT), using degree of difficulty and discriminating items as parameters. Results: Median age was 52 years old, median APACHE II score was 15. Median ICU stay was 11 days and median MV duration was 4 days. BI variation was 44% and KI variation was 55%. In IRT analysis, BI considered a larger number of items with different levels of difficulty. Conclusion: Both the BI and the KI revealed significant deterioration of functional status after ICU discharge. The IRT analysis suggested that the Barthel Index might be a better scale than the Katz Index for the assessment of functional status of patients discharged from ICU, since it presented better discrimination of the ability to carry out the tasks.