Janaína Feijó - Academia.edu (original) (raw)

Papers by Janaína Feijó

Revista Brasileira De Terapia Intensiva, Sep 1, 2010

Estimate of the economic impact of implementing an in hospital protocol for the early detection a... more Estimate of the economic impact of implementing an in hospital protocol for the early detection and treatment of severe sepsis in public and private hospitals in southern Brazil Estimativa do impacto econômico da implantação de um protocolo hospitalar para detecção e tratamento precoce de sepse grave em hospitais púbicos e privados do sul do Brasil

Notas Técnicas, Sep 9, 2022

Fundação pública vinculada ao Ministério da Economia, o Ipea fornece suporte técnico e institucio... more Fundação pública vinculada ao Ministério da Economia, o Ipea fornece suporte técnico e institucional às ações governamentais-possibilitando a formulação de inúmeras políticas públicas e programas de desenvolvimento brasileiros-e disponibiliza, para a sociedade, pesquisas e estudos realizados por seus técnicos.

Revista Brasileira De Terapia Intensiva, 2009

Journal of Critical Care, 2011

Objective: We evaluate the impact that implementing an in-hospital protocol for the early detecti... more Objective: We evaluate the impact that implementing an in-hospital protocol for the early detection of sepsis risk has on mortality from severe sepsis/septic shock. Methods: This was a prospective cohort study conducted in 2 phases at 2 general hospitals in Brazil. In phase I, patients with severe sepsis/septic shock were identified and treated in accordance with the Surviving Sepsis Campaign guidelines. Over the subsequent 12 months (phase II), patients with severe sepsis/septic shock were identified by means of active surveillance for signs of sepsis risk (SSR). We compared the 2 cohorts in terms of demographic variables, the time required for the identification of at least 2 SSRs, compliance with sepsis bundles (6-and 24-hour), and mortality rates. Results: We identified 217 patients with severe sepsis/septic shock (102 during phase I and 115 during phase II). There were significant differences between phases I and II in terms of the time required for the identification of at least 2 SSRs (34 ± 48 vs 11 ± 17 hours; P b .001) and in terms of in-hospital mortality (61.7% vs 38.2%; P b .001). Conclusion: The early detection of sepsis promoted early treatment, reducing in-hospital mortality from severe sepsis/septic shock.

Revista Brasileira de terapia intensiva, 2010

To analyze the economic impact of an early sepsis detection protocol in two general hospitals. We... more To analyze the economic impact of an early sepsis detection protocol in two general hospitals. We analyzed data collected from a prospective study of septic patients before and after the implementation of a protocol for early diagnosis of severe sepsis. We conducted a cost-effectiveness analysis comparing: mortality rate, cost of sepsis treatment and indirect costs attributed to years of productive life lost to premature death in both phases. Two hundred seventeen patients were included, 102 in phase I and 115 in phase II. After protocol implementation, in private and public hospital, mortality rates decreased from 50% to 32.2% and from 67.6% to 41% (p < 0.05). The mean years of productive life lost due to sepsis decreased from 3.18 to 0.80 and 9.81 to 4.65 (p < 0.05), with a mean gain of 2.38 and 5.16 years of productive life, for each septic patient. Considering Brazilian gross domestic product per capita, estimated productivity loss due to sepsis decreased between 3.2 and 9...

Revista Brasileira de terapia intensiva, 2009

To evaluate the impact of implementing an institutional policy for detection of severe sepsis and... more To evaluate the impact of implementing an institutional policy for detection of severe sepsis and septic shock. Study before (stage I), after (stage II) with prospective data collection in a 195 bed public hospital.. Stage I: Patients with severe sepsis or septic shock were included consecutively over 15 months and treated according to the Surviving Sepsis Campaign guidelines. Stage II: In the 10 subsequent months, patients with severe sepsis or septic shock were enrolled based on an active search for signs suggesting infection (SSI) in hospitalized patients. The two stages were compared for demographic variables, time needed for recognition of at least two signs suggesting infection (SSI-Δt), compliance to the bundles of 6 and 24 hours and mortality. We identified 124 patients with severe sepsis or septic shock, 68 in stage I and 56 in stage II. The demographic variables were similar in both stages. The Δt-SSI was 34 ± 54 hours in stage I and 7 ± 8.4 hours in stage II (p <0.001)...

Revista Brasileira de Terapia Intensiva, 2009

Early detection strategy and mortality reduction in severe sepsis Artigo originAl introDUÇÃo Seps... more Early detection strategy and mortality reduction in severe sepsis Artigo originAl introDUÇÃo Sepse é o conjunto de reações, por vezes dramáticas e catastróficas, desenvolvidas pelo ser humano em resposta à invasão de microorganismos patogênicos. É uma síndrome clínica que se manifesta em espectros distintos de gravidade. Caso não diagnosticada e tratada corretamente, pode agravar-se com o decorrer do tempo. Usualmente, o início do quadro clínico se manifesta com alterações inespecíficas e sutis dos sinais vitais como taquicardia e taquipnéia. (1)(2)(3)(4) Por suas manifestações, grosso modo, não serem marcadas por um ictus como acontece no infarto agudo do miocárdio (IAM) ou no acidente vascular isquêmico cerebral (AVCi), a sepse freqüentemente passa despercebida até estágios avançados, mesmo dentro de ambientes hospitalares. (4) O diagnóstico da síndrome séptica é clinico, baseando-se nas alterações que constituem a síndrome da resposta inflamatória sistêmica (SIRS). Foi definida em

Journal of Critical Care, 2011

Objective: We evaluate the impact that implementing an in-hospital protocol for the early detecti... more Objective: We evaluate the impact that implementing an in-hospital protocol for the early detection of sepsis risk has on mortality from severe sepsis/septic shock. Methods: This was a prospective cohort study conducted in 2 phases at 2 general hospitals in Brazil. In phase I, patients with severe sepsis/septic shock were identified and treated in accordance with the Surviving Sepsis Campaign guidelines. Over the subsequent 12 months (phase II), patients with severe sepsis/septic shock were identified by means of active surveillance for signs of sepsis risk (SSR). We compared the 2 cohorts in terms of demographic variables, the time required for the identification of at least 2 SSRs, compliance with sepsis bundles (6-and 24-hour), and mortality rates. Results: We identified 217 patients with severe sepsis/septic shock (102 during phase I and 115 during phase II). There were significant differences between phases I and II in terms of the time required for the identification of at least 2 SSRs (34 ± 48 vs 11 ± 17 hours; P b .001) and in terms of in-hospital mortality (61.7% vs 38.2%; P b .001). Conclusion: The early detection of sepsis promoted early treatment, reducing in-hospital mortality from severe sepsis/septic shock.

Revista Brasileira De Terapia Intensiva, Sep 1, 2010

Estimate of the economic impact of implementing an in hospital protocol for the early detection a... more Estimate of the economic impact of implementing an in hospital protocol for the early detection and treatment of severe sepsis in public and private hospitals in southern Brazil Estimativa do impacto econômico da implantação de um protocolo hospitalar para detecção e tratamento precoce de sepse grave em hospitais púbicos e privados do sul do Brasil

Notas Técnicas, Sep 9, 2022

Fundação pública vinculada ao Ministério da Economia, o Ipea fornece suporte técnico e institucio... more Fundação pública vinculada ao Ministério da Economia, o Ipea fornece suporte técnico e institucional às ações governamentais-possibilitando a formulação de inúmeras políticas públicas e programas de desenvolvimento brasileiros-e disponibiliza, para a sociedade, pesquisas e estudos realizados por seus técnicos.

Revista Brasileira De Terapia Intensiva, 2009

Journal of Critical Care, 2011

Objective: We evaluate the impact that implementing an in-hospital protocol for the early detecti... more Objective: We evaluate the impact that implementing an in-hospital protocol for the early detection of sepsis risk has on mortality from severe sepsis/septic shock. Methods: This was a prospective cohort study conducted in 2 phases at 2 general hospitals in Brazil. In phase I, patients with severe sepsis/septic shock were identified and treated in accordance with the Surviving Sepsis Campaign guidelines. Over the subsequent 12 months (phase II), patients with severe sepsis/septic shock were identified by means of active surveillance for signs of sepsis risk (SSR). We compared the 2 cohorts in terms of demographic variables, the time required for the identification of at least 2 SSRs, compliance with sepsis bundles (6-and 24-hour), and mortality rates. Results: We identified 217 patients with severe sepsis/septic shock (102 during phase I and 115 during phase II). There were significant differences between phases I and II in terms of the time required for the identification of at least 2 SSRs (34 ± 48 vs 11 ± 17 hours; P b .001) and in terms of in-hospital mortality (61.7% vs 38.2%; P b .001). Conclusion: The early detection of sepsis promoted early treatment, reducing in-hospital mortality from severe sepsis/septic shock.

Revista Brasileira de terapia intensiva, 2010

To analyze the economic impact of an early sepsis detection protocol in two general hospitals. We... more To analyze the economic impact of an early sepsis detection protocol in two general hospitals. We analyzed data collected from a prospective study of septic patients before and after the implementation of a protocol for early diagnosis of severe sepsis. We conducted a cost-effectiveness analysis comparing: mortality rate, cost of sepsis treatment and indirect costs attributed to years of productive life lost to premature death in both phases. Two hundred seventeen patients were included, 102 in phase I and 115 in phase II. After protocol implementation, in private and public hospital, mortality rates decreased from 50% to 32.2% and from 67.6% to 41% (p < 0.05). The mean years of productive life lost due to sepsis decreased from 3.18 to 0.80 and 9.81 to 4.65 (p < 0.05), with a mean gain of 2.38 and 5.16 years of productive life, for each septic patient. Considering Brazilian gross domestic product per capita, estimated productivity loss due to sepsis decreased between 3.2 and 9...

Revista Brasileira de terapia intensiva, 2009

To evaluate the impact of implementing an institutional policy for detection of severe sepsis and... more To evaluate the impact of implementing an institutional policy for detection of severe sepsis and septic shock. Study before (stage I), after (stage II) with prospective data collection in a 195 bed public hospital.. Stage I: Patients with severe sepsis or septic shock were included consecutively over 15 months and treated according to the Surviving Sepsis Campaign guidelines. Stage II: In the 10 subsequent months, patients with severe sepsis or septic shock were enrolled based on an active search for signs suggesting infection (SSI) in hospitalized patients. The two stages were compared for demographic variables, time needed for recognition of at least two signs suggesting infection (SSI-Δt), compliance to the bundles of 6 and 24 hours and mortality. We identified 124 patients with severe sepsis or septic shock, 68 in stage I and 56 in stage II. The demographic variables were similar in both stages. The Δt-SSI was 34 ± 54 hours in stage I and 7 ± 8.4 hours in stage II (p <0.001)...

Revista Brasileira de Terapia Intensiva, 2009

Early detection strategy and mortality reduction in severe sepsis Artigo originAl introDUÇÃo Seps... more Early detection strategy and mortality reduction in severe sepsis Artigo originAl introDUÇÃo Sepse é o conjunto de reações, por vezes dramáticas e catastróficas, desenvolvidas pelo ser humano em resposta à invasão de microorganismos patogênicos. É uma síndrome clínica que se manifesta em espectros distintos de gravidade. Caso não diagnosticada e tratada corretamente, pode agravar-se com o decorrer do tempo. Usualmente, o início do quadro clínico se manifesta com alterações inespecíficas e sutis dos sinais vitais como taquicardia e taquipnéia. (1)(2)(3)(4) Por suas manifestações, grosso modo, não serem marcadas por um ictus como acontece no infarto agudo do miocárdio (IAM) ou no acidente vascular isquêmico cerebral (AVCi), a sepse freqüentemente passa despercebida até estágios avançados, mesmo dentro de ambientes hospitalares. (4) O diagnóstico da síndrome séptica é clinico, baseando-se nas alterações que constituem a síndrome da resposta inflamatória sistêmica (SIRS). Foi definida em

Journal of Critical Care, 2011

Objective: We evaluate the impact that implementing an in-hospital protocol for the early detecti... more Objective: We evaluate the impact that implementing an in-hospital protocol for the early detection of sepsis risk has on mortality from severe sepsis/septic shock. Methods: This was a prospective cohort study conducted in 2 phases at 2 general hospitals in Brazil. In phase I, patients with severe sepsis/septic shock were identified and treated in accordance with the Surviving Sepsis Campaign guidelines. Over the subsequent 12 months (phase II), patients with severe sepsis/septic shock were identified by means of active surveillance for signs of sepsis risk (SSR). We compared the 2 cohorts in terms of demographic variables, the time required for the identification of at least 2 SSRs, compliance with sepsis bundles (6-and 24-hour), and mortality rates. Results: We identified 217 patients with severe sepsis/septic shock (102 during phase I and 115 during phase II). There were significant differences between phases I and II in terms of the time required for the identification of at least 2 SSRs (34 ± 48 vs 11 ± 17 hours; P b .001) and in terms of in-hospital mortality (61.7% vs 38.2%; P b .001). Conclusion: The early detection of sepsis promoted early treatment, reducing in-hospital mortality from severe sepsis/septic shock.