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1.
Säo Paulo med. j ; 139(2): 170-177, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1181006

ABSTRACT

ABSTRACT BACKGROUND: Healthcare institutions are confronted with large numbers of patient admissions during large-scale or long-term public health emergencies like pandemics. Appropriate and effective triage is needed for effective resource use. OBJECTIVES: To evaluate the effectiveness of the Pandemic Medical Early Warning Score (PMEWS), Simple Triage Scoring System (STSS) and Confusion, Uremia, Respiratory rate, Blood pressure and age ≥ 65 years (CURB-65) score in an emergency department (ED) triage setting. DESIGN AND SETTING: Retrospective study in the ED of a tertiary-care university hospital in Düzce, Turkey. METHODS: PMEWS, STSS and CURB-65 scores of patients diagnosed with COVID-19 pneumonia were calculated. Thirty-day mortality, intensive care unit (ICU) admission, mechanical ventilation (MV) need and outcomes were recorded. The predictive accuracy of the scores was assessed using receiver operating characteristic curve analysis. RESULTS: One hundred patients with COVID-19 pneumonia were included. The 30-day mortality was 6%. PMEWS, STSS and CURB-65 showed high performance for predicting 30-day mortality (area under the curve: 0.968, 0.962 and 0.942, respectively). Age > 65 years, respiratory rate > 20/minute, oxygen saturation (SpO2) < 90% and ED length of stay > 4 hours showed associations with 30-day mortality (P < 0.05). CONCLUSIONS: CURB-65, STSS and PMEWS scores are useful for predicting mortality, ICU admission and MV need among patients diagnosed with COVID-19 pneumonia. Advanced age, increased respiratory rate, low SpO2 and prolonged ED length of stay may increase mortality. Further studies are needed for developing the triage scoring systems, to ensure effective long-term use of healthcare service capacity during pandemics.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Pneumonia/diagnosis , Pneumonia/epidemiology , Triage/methods , Risk Assessment/methods , Emergency Service, Hospital/statistics & numerical data , Early Warning Score , COVID-19/therapy , Turkey , Uremia/etiology , Uremia/epidemiology , Blood Pressure , Retrospective Studies , Respiratory Rate/physiology , Pandemics , SARS-CoV-2 , COVID-19/diagnosis , COVID-19/epidemiology
2.
Med. infant ; 27(2): 162-168, Diciembre 2020. ilus, Tab
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1150600

ABSTRACT

El triage hospitalario en los servicios de urgencias es un proceso de valoración clínica preliminar. Permite clasificar a los pacientes según su nivel de urgencia y no por orden de llegada. Prioriza la asistencia de los pacientes graves. Organiza la atención de acuerdo a la demanda, los recursos físicos y humanos disponibles. Debe incluir protocolos que definan la clasificación del nivel de urgencia, los tiempos de asistencia y reevaluación, las intervenciones que se pueden ejecutar en el sector y el registro de las actuaciones. La clasificación del nivel de urgencia se define mediante el triángulo de evaluación pediátrica, el problema principal, las constantes vitales y la consideración de modificadores o alertas. Aunque resulta imprescindible, su uso no está uinversalmente difundido(AU)


At emergency departments, triage is the process of initial clinical assessment. It allows for the classification of patients based on their level of emergency regardless of order of arrival. It prioritizes care for severe patients and organizes care according to the demand and available physical and human resources. The triage should include protocols that define classification of the level of urgency, necessary times for care and reassessment, interventions that may be performed in the area, and recording of the activities. The level of emergency is classified based on the triad of pediatric assessment, consisting of the main complaint, vital signs, and consideration of modifiers or alerts. Although essential, it is not universally used (AU).


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Severity of Illness Index , Triage/methods , Triage/organization & administration , Emergency Service, Hospital/organization & administration
7.
Arq. bras. cardiol ; 114(5): 795-802, maio 2020. tab, graf
Article in Portuguese | LILACS, SES-SP | ID: biblio-1131233

ABSTRACT

Resumo Fundamento Múltiplos sistemas de pontuação têm sido elaborados para calcular o risco de eventos cardiovasculares adversos maiores (MACE) em pacientes com dor no peito. Não há dados que avaliem se o escore HEART tem um desempenho superior a TIMI e GRACE para a predição de MACE, especialmente na era de troponina I de alta sensibilidade e em uma população exclusivamente latino-americana. Objetivo Comparar o desempenho dos escores HEART, TIMI e GRACE para a predição de MACE em 30 dias de acompanhamento, em pacientes atendidos com dor no peito no departamento de emergência. Métodos Os escores HEART, TIMI e GRACE foram analisados em 519 pacientes com dor no peito no departamento de emergência. O desfecho primário foi a ocorrência de MACE no período de 30 dias. O desempenho do escore HEART foi comparado com o dos escores TIMI e GRACE utilizando o teste de DeLong, considerando estatisticamente significativos os valores de p de 0,05. Resultados Um total de 224 pacientes (43%) apresentaram MACE no período de 30 dias. A estatística C para os escores HEART, TIMI e GRACE foi de 0,937, 0,844 e 0,797 respectivamente (p < 0,0001). Uma pontuação de 3 ou menos no escore HEART apresentou uma sensibilidade de 99,5% e um valor preditivo negativo de 99% para classificar pacientes de baixo risco de maneira correta; ambos os valores foram mais elevados do que aqueles obtidos pelos outros escores. Conclusão O escore HEART, em um período de 30 dias, prediz eventos cardiovasculares, mais eficazmente, em comparação com os outros escores. Troponinas de alta sensibilidade mantêm a superioridade previamente demonstrada deste escore. Este escore oferece uma identificação mais precisa dos pacientes de baixo risco. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)


Abstract Background Multiple scoring systems have been designed to calculate the risk of major adverse cardiovascular events (MACE) in patients with chest pain. There is no data on whether the HEART score outperforms TIMI and GRACE in the prediction of MACE, especially in the era of high-sensitivity troponin assay and in an exclusively Latin-American population. Objective To compare the performance of the HEART, TIMI, and GRACE scores for predicting major cardiovascular events at 30 days of follow-up, in patients who consult for chest pain in the emergency department. Methods HEART, TIMI, and GRACE scores were analyzed in 519 patients with chest pain at the emergency department. The primary endpoint was the occurrence of MACE within 30 days. The performance of the HEART score was compared with the TIMI and GRACE scores using the DeLong test with p values of 0.05 considered statistically significant. Results A total of 224 patients (43%) had MACE at 30 days. The C statistic for the HEART, TIMI, and GRACE score was 0.937, 0.844, and 0.797 respectively (p < 0.0001). A HEART score of 3 or less had a sensitivity of 99.5% and a negative predictive value of 99% to classify low risk patients correctly; both values were higher than those obtained by the other scores. Conclusion The HEART score more effectively predicts cardiovascular events at 30 days of follow-up compared to the other scores. High-sensitivity troponins maintain this score's previously demonstrated superiority. This score offers more precise identification of low-risk patients. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)


Subject(s)
Humans , Male , Female , Chest Pain/diagnosis , Cardiovascular Diseases/diagnosis , Risk Assessment/methods , Acute Coronary Syndrome/diagnosis , Heart Diseases/diagnosis , Troponin , Severity of Illness Index , Predictive Value of Tests , Prospective Studies , Triage/methods , Emergency Service, Hospital
12.
Aparecida do Rio Negro; [S.n]; 2020. 16 p.
Non-conventional in Portuguese | LILACS, ColecionaSUS, CONASS, SES-TO | ID: biblio-1123367

ABSTRACT

Traz recomendações e orientações para ações de combate ao Coronavírus (Covid-19) no município de Aparecida do Rio Negro no Tocantins.


It provides recommendations and guidelines for actions to combat the Coronavirus (Covid-19) in the municipality of Aparecida do Rio Negro in Tocantins.


Brinda recomendaciones y lineamientos para acciones de combate al Coronavirus (Covid-19) en el municipio de Aparecida do Rio Negro en Tocantins.


Il fournit des recommandations et des lignes directrices pour les actions de lutte contre le Coronavirus (Covid-19) dans la municipalité d'Aparecida do Rio Negro à Tocantins.


Subject(s)
Humans , Secondary Care/organization & administration , Universal Precautions/methods , Coronavirus Infections/prevention & control , Contingency Plans , Patient Isolation/methods , Triage/methods , Hand Hygiene/standards , Personal Protective Equipment/supply & distribution
15.
Clinics ; 75: e1923, 2020. tab, graf
Article in English | LILACS | ID: biblio-1133461

ABSTRACT

The coronavirus disease (COVID-19) outbreak </mac_aq>started in Wuhan, China, in December 2019, and evolved into a global problem in a short period. The pandemic has led to many social and health-care challenges. In this context, surgery is an area that is facing the need for many adaptations. In this systematic literature review, we analyzed different perspectives concerning this situation, aiming to provide recommendations that could guide surgeons and </mac_aq>entities toward screening, elective and emergency surgeries, decision making, and operating room management. A computerized search in PubMed, Scopus, and Scientific Electronic Library Online (SciELO) for relevant literature up to April 4, 2020, was performed. Articles were included if they were related to surgery dynamics in the context of the COVID-19 pandemic. Of the 281 articles found in our initial search and 15 articles from alternative sources, 39 were included in our review after a systematic evaluation. Concerning preoperative testing </mac_aq>for severe acute respiratory syndrome coronavirus 2 infection, 29 (74.4%) articles recommended some kind of </mac_aq>screening. Another major suggestion was postponing all (or at least selected) elective operations (29 articles, </mac_aq>74.4%). Several additional recommendations with respect to surgical practice or surgical staff were also assessed and discussed, such as performing laparoscopic surgeries and avoiding the use of electrocauterization. On the basis of the current literature, we concluded that any surgery that can be delayed should be postponed. COVID-19 screening is strongly recommended for all surgical cases. Moreover, surgical staff should be reduced to the essential members and provided with institutional psychological support.


Subject(s)
Humans , Operating Rooms/organization & administration , Pneumonia, Viral/prevention & control , Coronavirus Infections/prevention & control , Decision Making , Pandemics/prevention & control , Betacoronavirus , Pneumonia, Viral/epidemiology , Surgical Procedures, Operative/standards , Surgical Procedures, Operative/statistics & numerical data , Triage/methods , Coronavirus Infections/epidemiology , SARS-CoV-2 , COVID-19
16.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 12: 710-715, jan.-dez. 2020. graf, ilus, tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1099591

ABSTRACT

Objective: The study's main goal has been to characterize eligible patients for palliative care admitted to a university hospital. Method: This is a descriptive, cross-sectional, and quantitative study. Population sample was adopted, selecting patients over 18 years old, diagnosed with chronic disease, admitted to a university hospital, from June to July, 2019. Results: 44 patients participated, 29 (65.9%) female, 21 (47.7%) age group above 60 years old, 28 (63.6%) not married, 36 (81.8%) living with family; 23 (52.3%) admitted to the medical clinic, 39 (88.6%) reporting previous hospitalizations; 21 (45.5%) had heart disease, cancer or diabetes, 37 (84.1%) with comorbidities, 40 (90.9%) with continuous use medications, 24 (54.5%) smokers and 18 (40.9%) alcoholics. 95.5% of the participants were eligible for palliative care, using the instrument "Palliative Care Screening Tool" and 4.5% were under clinical observation. Conclusion: The research found that most participants in this study, suffering from chronic diseases and hospitalized, were indicated as eligible for palliative care, according to the scale Palliative Care Screening Tool


Objetivo: Caracterizar pacientes elegíveis para cuidados paliativos internados em um hospital universitário Método: Estudo descritivo, transversal, quantitativo. Adotou-se amostra populacional, por conveniência, selecionando pacientes maiores de 18 anos, internados num hospital universitário, apresentando diagnóstico de doenças crônicas, no período de junho a julho de 2019. Resultados: Participaram 44 pacientes: 21 (47,7%) acima de 60 anos, 29 (65,9%) do sexo feminino, 28 (63,6%) não casados, 36 (81,8%) morando com familiares; 23 (52,3%) internados na clínica médica, 39 (88,6%) relataram internações anteriores, 20 (45,5%) apresentaram doença cardíaca, câncer ou diabetes, 37 (84,1%) com comorbidades, 40 (90,9%) com medicações de uso contínuo, 24 (54,5%) tabagistas e 18 (40,9%) etilistas. Foram elegíveis pela Palliative Care Screening Tool, 95,5% dos participantes para cuidados paliativos e 4,5% ficaram em observação clínica. Conclusão: O estudo verificou que a maioria dos participantes deste estudo, acometidos por doenças crônicas e internados no hospital, foi indicado como elegíveis para os cuidados paliativos, segundo a escala Palliative Care Screnning Tool


Objetivo: El propósito del trabajo es caracterizar a pacientes elegibles para cuidados paliativos internados en un hospital universitario. Método: Este es un estudio descriptivo, transversal, y cuantitativo, en el que se adoptó una muestra de población, seleccionando pacientes mayores 18 años, presentando diagnóstico de enfermedad crónica, internados en un hospital universitario, en el período de junio a julio de 2019. Resultados: Participaron 44 pacientes, 29 (65,9%) del sexo femenino, 21 (47,7%) franja de edad superior a 60 años, 28 (63,6%) no casados, 36 (81,8%) viviendo con familiares; 23 (52,3%) internados en la clínica médica, 39 (88,6%) relatando internaciones anteriores; 20 (45,5%) tenían enfermedad cardíaca, cáncer y diabetes, 37 (84,1%) con comorbilidades, 40 (90,9%) con medicaciones de uso continuo, 24 (54,5%) fumadores y 18 (40,9%) alcohólicos. Fueron elegibles por la Palliative Care Screening Tool, 95,5% de los participantes para cuidados paliativos y 4,5% estaban bajo observación clínica. Conclusión: La investigación encontró que la mayoría de los participantes en este estudio, que padecían enfermedades crónicas y estaban hospitalizados, estaban indicados como elegibles para cuidados paliativos, según la escala Palliative Care Screnning Tool


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Palliative Care , Chronic Disease/epidemiology , Surveys and Questionnaires/statistics & numerical data , Triage/methods , Quality of Life , Inpatient Care Units , Hospitals, University
17.
Rev. bras. enferm ; 72(6): 1496-1503, Nov.-Dec. 2019.
Article in English | LILACS, BDENF | ID: biblio-1042194

ABSTRACT

ABSTRACT Objective: to describe the conception of justice of nurses and users regarding the Risk Classification in Emergency Unit; to analyze the conception of justice in the implementation of the Risk Classification in Emergency Unit from the user's recognition; to discuss, from Axel Honneth's Theory of Recognition, justice with the user in the Risk Classification in Emergency Unit. Method: qualitative research of descriptive, exploratory typology, which used action research as a method. Bardin's Content Analysis was carried out. Results: a category was created: "Justice versus Injustice" and three subcategories: "Autonomy/Freedom versus Heteronomy/Subordination"; "Communication versus Hermeneutic Problems"; "Contributions versus Conflicts". Final considerations: Embracement with Risk Classification presents difficulties in its interpretation and effectiveness; there are situations of disrespect that compete against the required ethics. Justice addressed by this study will be achieved by an emergency access system that meets user expectations, recognizing it as a subject of rights.


RESUMEN Objetivo: describir la concepción de justicia de enfermeros y usuarios en la Clasificación de Riesgo en Emergencia; analizar la concepción de justicia en la implementación de la Clasificación de Riesgo en la Emergencia a partir del reconocimiento del usuario; discutir, a partir de la Teoría del Reconocimiento de Axel Honneth, la justicia con el usuario en la Clasificación de Riesgo en Unidad de Emergencia. Método: investigación cualitativa de tipología descriptiva, exploratoria, que utilizó como método la investigación-acción. Análisis de Contenido de Bardin. Resultados: se organizó una categoría: "Justicia versus Injusticia" y tres subcategorías: "Autonomía/Libertad versus Heteronomía/Subordinación"; "Comunicación versus Problemas Hermenéuticos"; "Contribuciones versus Conflictos". Consideraciones finales: Acogida con Clasificación de Riesgo presenta dificultades en su interpretación y efectividad, con situaciones de incumplimiento que concurren contra la ética requerida. La justicia de que trata este estudio será alcanzada por un sistema de acceso a las emergencias que alcance las expectativas del usuario, reconociéndolo como sujeto de derechos.


RESUMO Objetivo: descrever a concepção de justiça de enfermeiros e usuários na Classificação de Risco em Emergência; analisar a concepção de justiça na implementação da Classificação de Risco na Emergência a partir do reconhecimento do usuário; discutir, a partir da Teoria do Reconhecimento de Axel Honneth, a justiça com o usuário na Classificação de Risco em Unidade de Emergência. Método: pesquisa qualitativa de tipologia descritiva, exploratória, que utilizou como método a pesquisa-ação. Análise de Conteúdo de Bardin. Resultados: foi organizada uma categoria: "Justiça versus Injustiça" e três subcategorias: "Autonomia/Liberdade versus Heteronomia/Subordinação"; "Comunicação versus Problemas Hermenêuticos"; "Contribuições versus Conflitos". Considerações finais: o Acolhimento com Classificação de Risco apresenta dificuldades em sua interpretação e efetividade, com situações de desrespeito que concorrem contra a ética requerida. A justiça de que trata esse estudo será alcançada por um sistema de acesso às emergências que atinja as expectativas do usuário, reconhecendo-o como sujeito de direitos.


Subject(s)
Humans , Female , Adult , Social Justice , Triage/methods , Risk Assessment/methods , Emergencies/classification , Emergency Service, Hospital , Problem Solving , Time Factors , Communication , Conflict, Psychological , Personal Autonomy , Qualitative Research , Dominance-Subordination , Educational Status , Hermeneutics , Freedom , Middle Aged , Nursing Staff, Hospital
18.
Int. j. cardiovasc. sci. (Impr.) ; 32(5): 438-446, Sept-Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1040107

ABSTRACT

Distress has a potentiating effect on complications of heart disease. Early identification of distress and psychosocial management could help patients to deal with the disease and improve their quality of life. However, in Brazil, there is no specific instrument for evaluation of distress in cardiac patients. Objectives: To describe the validation process of the Screening Tool for Psychosocial Distress (STOP-D) for the Brazilian population. Methods: Cross-sectional, observational study with a quantitative approach. A total of 144 patients (including outpatients and inpatients) were interviewed at the waiting room of the outpatient cardiology clinic or in cardiology wards. Sociodemographic and clinical data were collected, and distress was assessed using two instruments - the Brazilian version of the STOP-D and the Hospital Anxiety and Depression Scale (HADS). First, we performed an exploratory factor analysis and analysis of the accuracy of the STOP-D score by the receiver operating characteristic (ROC) curvet. Results: The factorability analysis of the correlation matrix did not detect any factor that made the factorial solution unfeasible. The instrument showed a single-factor nature, confirmed by the criterion of eigenvalues, with an 85% accuracy in predicting distress. A cut-off point of 15.5 was chosen for distress using the ROC curve. Conclusions: The Brazilian version of the STOP-D is an adequate instrument for the screening of heart disease patient for distress. It can be easily used by any health professional and would contribute to the promotion of a comprehensive support to cardiac patients


Subject(s)
Humans , Male , Female , Adolescent , Adult , Aged , Aged, 80 and over , Stress, Psychological , Cardiovascular Diseases , Validation Study , Anxiety , Social Conditions , Sex Factors , Statistical Analysis , Surveys and Questionnaires , ROC Curve , Factor Analysis, Statistical , Triage/methods , Depression , Observational Study
19.
Rev. bras. enferm ; 72(4): 1013-1019, Jul.-Aug. 2019. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1020531

ABSTRACT

ABSTRACT Objective: to analyze the care flow for women victims of Road Traffic Accidents (RTA). Method: a descriptive study with 782 women victims of RAT, classified by the Manchester Triage System (MTS) between 2015 and 2016. The sociodemographic profile and the time between the stages of care were analyzed, as well as care place and outcomes. Results: of the women in the study, 65.47% were young adults, 80.44% lived without a partner and 62.28% lived in the city of Belo Horizonte. Regarding the time between recording and risk classification, the mean was 7.7 minutes (SD: 9.9). The prevalent flowchart was "Great Trauma" (62.92%). 53.07% had "Red/Orange" priority level and the most prevalent outcome was "Discharge after consultation/medication". Conclusion: the study shows that the hospital partially fulfills the times recommended by the MTS. Analyzing the flow of women victims of RAT contributed to optimize the quality and efficiency of care.


RESUMEN Objetivo: analizar el flujo de atención de mujeres víctimas de Accidentes de Transporte Terrestre (ATT). Método: estudio descriptivo, con 782 mujeres víctimas de ATT, clasificadas por el Sistema de Triaje de Manchester (STM), entre 2015 y 2016. Se analizó el perfil sociodemográfico y el tiempo entre las etapas de la atención, así como el local de atención y desenlace. Resultados: de las mujeres del estudio, el 65,47% eran adultas jóvenes, el 80,44% vivía sin compañero (a) y el 62,28% residían en la ciudad de Belo Horizonte. En cuanto al tiempo entre el registro y la clasificación de riesgo, se presentó promedio de 7,7 minutos (DE: 9,9). El diagrama de flujo prevalente fue "Gran Traumatismo" (62,92%). El 53,07% obtuvo un nivel de prioridad "Rojo/Naranja" y el resultado más prevalente fue "Alta tras consulta/medicación". Conclusión: el estudio evidencia que el hospital cumple parcialmente los tiempos preconizados por el STM. El análisis del flujo de mujeres víctimas de ATT contribuyó a optimizar la calidad y eficiencia de la asistencia.


RESUMO Objetivo: analisar o fluxo do atendimento a mulheres vítimas de Acidentes de Transporte Terrestre (ATT). Método: estudo descritivo, com 782 mulheres vítimas de ATT, classificadas pelo Sistema de Triagem de Manchester (STM), entre 2015 a 2016. Analisou-se o perfil sociodemográfico e o tempo entre as etapas do atendimento, bem como o local de atendimento e desfecho. Resultados: das mulheres do estudo, 65,47% eram adultas jovens, 80,44% viviam sem companheiro(a) e 62,28% residiam em Belo Horizonte. Em relação ao tempo entre o registro e a classificação de risco, apresentou-se média de 7,7 minutos (DP:9,9). O fluxograma prevalente foi "Grande Traumatismo" (62,92%). 53,07% obteve nível de prioridade "Vermelho/Laranja" e o desfecho mais prevalente foi "Alta após consulta/medicação". Conclusão: o estudo evidencia que o hospital cumpre parcialmente os tempos preconizados pelo STM. Analisar o fluxo de mulheres vítimas de ATT contribuiu para otimizar a qualidade e eficiência da assistência.


Subject(s)
Humans , Female , Adolescent , Adult , Aged , Aged, 80 and over , Wounds and Injuries/therapy , Accidents, Traffic/statistics & numerical data , Triage/standards , Wounds and Injuries/complications , Wounds and Injuries/epidemiology , Brazil/epidemiology , Injury Severity Score , Triage/methods , Triage/statistics & numerical data , Hospitalization/statistics & numerical data , Middle Aged
20.
Dement. neuropsychol ; 13(1): 31-43, Jan.-Mar. 2019. tab, graf
Article in English | LILACS | ID: biblio-989672

ABSTRACT

ABSTRACT. Screening instruments are ideal for acute clinical settings because they are easy to apply, fast, inexpensive and sensitive for specific samples. However, there is a need to verify the psychometric properties of screening in stroke patients. Objective: This study investigated the psychometric properties (methodological procedures) of cognitive screening for patients with cerebrovascular diseases. Methods: A systematic review of papers published on PsycINFO, Web of Knowledge, PubMed and Science Direct (2005 to 2016) was performed. Results: A total of 55 articles remained after applying exclusion criteria. The samples ranged from 20 to 657 patients. Most articles evaluated elderly individuals with four to 13 years of education who had experienced ischemic or hemorrhagic stroke. There was a tendency to find evidence of validity for criteria and to analyze the sensitivity/specificity of the instruments. Although the studies frequently used the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) to seek evidence of validity and reliability, the use of these instruments among stroke patients has been criticized due to their psychometric properties and the neuropsychological functions evaluated. Conclusion: Although there is no gold standard screen for assessing adults post-stroke, instruments devised specifically for this population have shown promise. This review helps both researchers and clinicians to select the most appropriate screen for identifying cognitive impairment in adults post-stroke.


RESUMO. Instrumentos de triagem são ideias no contexto clínico hospitalar, uma vez que são fáceis de administrar, rápidos, tem baixo custo e são sensíveis para amostras específicas. Portanto, há a necessidade de se verificar as propriedades psicométricas de instrumentos de triagem para pacientes pós acidente vascular cerebral. Objetivo: Este estudo investigou as propriedades psicométricas (procedimentos metodológicos) de triagens cognitivas para pacientes com doenças cerebrovasculares. Métodos: Foi realizada uma revisão sistemática de artigos publicados em PsycINFO, Web of Knowledge, PubMed e Science Direct (2005 a 2016). Apenas 55 artigos permaneceram após a aplicação dos critérios de exclusão. Resultados: As amostras variaram de 20 a 657 pacientes; a maioria dos artigos avaliou indivíduos idosos, com quatro a 13 anos de educação, que sofreram AVC isquêmico e hemorrágico. Houve uma tendência para encontrar evidências de validade relacionadas ao critério e analisar a sensibilidade/especificidade dos instrumentos. Embora os estudos frequentemente apliquem o Mini Exame do Estado Mental (MMSE) e o Montreal Cognitive Assessment (MoCA) para buscar evidências de validade e de fidedignidade, o uso desses instrumentos em pacientes com AVC é criticado por razões relacionadas às suas propriedades psicométricas e funções neuropsicológicas avaliadas. Conclusão: Embora não exista uma triagem padrão-ouro para avaliação de adultos pós-AVC, os instrumentos construídos especificamente para esta população mostraram-se promissores. Este estudo de revisão contribui tanto aos pesquisadores quanto aos clínicos que desejam selecionar o rastreio mais apropriado para identificar comprometimento cognitivo em adultos pós-AVC.


Subject(s)
Humans , Stroke , Triage/methods , Cognitive Dysfunction , Mental Status and Dementia Tests
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