Modelos prognósticos e Nursing Activities Score na avaliação do paciente com injúria renal aguda grave

Autores

Palavras-chave:

Escores de Disfunção Orgânica, Unidades de Terapia Intensiva, Gravidade do Paciente, Mortalidade, Enfermagem

Resumo

Objetivo: Analisar os escores prognósticos e a carga de trabalho de Enfermagem em pacientes críticos com injúria renal aguda grave submetidos à terapia de suporte renal.

Método: Estudo observacional realizado com 27 pacientes em uma Unidade de Terapia Intensiva para adultos de um hospital de ensino do Distrito Federal. Foram avaliados dados clínicos e calculados os escores Sequential Organ Failure Assessment, Simplified Acute Physiology Score 3, Nursing Activities Score e o estadiamento renal segundo Kidney Disease: Improving Global Outcomes. A análise foi realizada com o auxílio do software Statistical Package for the Social Sciences. 

Resultados: Pacientes que evoluíram para óbito apresentaram idade mais elevada (p=0,05). Houve tendência a maiores escores prognósticos entre os não sobreviventes, sem significância estatística (p=0,08). A carga de trabalho de Enfermagem foi elevada em toda a amostra.

Conclusão: Os achados evidenciaram elevada gravidade clínica e alta complexidade assistencial em pacientes críticos com injúria renal aguda grave submetidos à terapia de suporte renal.

Biografia do Autor

Kamilla Grasielle Nunes da Silva, Hospital Universitário de Brasília

Enfermeira. Mestre em Enfermagem. Hospital Universitário de Brasília-HUB, Brasília, DF, Brasil.

Yohann’s Ribeiro Vignoli , Centro Universitário do Distrito Federal

Enfermeiro. Centro Universitário do Distrito Federal, Brasília, DF, Brasil.

Breno de Sousa Santana , Centro Universitário do Distrito Federal

Enfermeiro. Mestre em Enfermagem. Docente no Centro Universitário do Distrito
Federal, Brasília, DF, Brasil.

Alcyellen Feitosa Abreu , Centro Universitário do Distrito Federal

Enfermeira. Docente no Centro Universitário do Distrito Federal, Brasília, DF, Brasil.

Nélia da Silva Inacio , Centro Universitário do Distrito Federal

Enfermeira. Docente no Centro Universitário do Distrito Federal, Brasília, DF, Brasil.

Marcia Cristina da Silva Magro , Universidade de Brasília

Enfermeira. Doutora em Enfermagem. Docente na Universidade de Brasília, Brasília, DF, Brasil.

Referências

1. KDIGO. Scope of work: KDIGO clinical practice guideline for acute kidney injury (aki) and acute kidney disease (akd) update 2023 [Internet]. 2023 [cited 2026 Jun 12]. p. 1-20. Available from: https://kdigo.org/wp-content/uploads/2023/10/KDIGO-AKI-Guideline_Scope-of-Work_25Oct2023_Final.pdf

2. Khwaja A. KDIGO Clinical practice guidelines for acute kidney injury. Nephron Clin Pract [Internet]. 2012 [cited 2026 Jun 12];120(4):c179-c184. Available from: https://doi.org/10.1159/000339789

3. Ostermann M, Lumlertgul N, Jeong R, See E, Joannidis M, James M. Acute kidney injury. Lancet [Internet]. 2025 Jan 16 [cited 2026 Jun 12];405(10474):241-56. Available from: https://doi.org/10.1016/S0140-6736(24)02385-7

4. Pan HC, Chen HY, Teng NC, Yeh FY, Huang TM, See CY, et al. Recovery dynamics and prognosis after dialysis for acute kidney injury. JAMA Netw Open [Internet]. 2024 [cited 2026 Jun 12];7(3):e240351. Available from: https://doi.org/10.1001/jamanetworkopen.2024.0351

5. Martins R, Koyner J, Wald R, Harenski K, Echeverri J. Cost-utility analysis of renal replacement therapy modalities in the management of severe acute kidney injury in US critically ill patients. Clinicoecon Outcomes Res [Internet]. 2025 [cited 2026 Jun 12];17:931-944. Available from: https://doi.org/10.2147/CEOR.S546850

6. Zhou J, Li H, Cheng B, Cao R, Zou F, Yang D, et al. Derivation and validation of a prognostic scoring model based on clinical and pathological features for risk stratification in oral squamous cell carcinoma patients: a retrospective multicenter study. Front Oncol [Internet]. 2021 May [cited 2026 Jun 12];11:652553. Available from: https://doi.org/10.3389/fonc.2021.652553

7. Hwang SY, Kim IK, Jeong D, Park JE, Lee GT, Yoo J, et al. Prognostic performance of Sequential Organ Failure Assessment, Acute Physiology and Chronic Health Evaluation III, and Simplified Acute Physiology Score II scores in patients with suspected infection according to intensive care unit type. J Clin Med [Internet]. 2023 [cited 2026 Jun 12];12(19):6402. Available from: https://doi.org/10.3390/jcm12196402

8. Vasconcelos GMT, Magro MCS, da Fonseca CD, Oliveira JC, Santana-Santos E. Predictive capacity of prognostic scores for kidney injury, dialysis, and death in intensive care units. Rev Esc Enferm USP [Internet]. 2021 [cited 2026 Jun 12];55:e20210071. Available from: https://doi.org/10.1590/1980-220X-REEUSP-2021-0071

9. Cerela-Boltunova O, Millere I. A six-month observational study of nursing workload in 14 latvian intensive care units using the nursing activities score. Healthcare (Basel) [Internet]. 2026 [cited 2026 Jun 12];14(1):134. Available from: https://doi.org/10.3390/healthcare14010134

10. Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med [Internet]. 2007 [cited 2026 Jun 12];147(8):573-7. Available from: https://doi.org/10.7326/0003-4819-147-8-200710160-00010

11. KDIGO. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease [Internet]. 2024 [cited 2026 Jun 12]. 199 p. Available from: https://kdigo.org/wp-content/uploads/2024/03/KDIGO-2024-CKD-Guideline.pdf

12. Kellum JA, Sileanu FE, Bihorac A, Hoste EAJ, Chawla LS. Recovery after acute kidney injury. Am J Respir Crit Care Med [Internet]. 2017 [cited 2026 Jun 12];195(6):784-91. Available from: https://doi.org/10.1164/rccm.201604-0799OC

13. Chawla LS, Bellomo R, Bihorac A, Goldstein SL, Siew ED, Bagshaw SM, et al. Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 workgroup. Nat Rev Nephrol [Internet]. 2017 [cited 2026 Jun 12];13:241-57. Available from: https://doi.org/10.1038/nrneph.2017.2

14. Lambden S, Laterre PF, Levy MM, Francois B. The SOFA score: development, utility and challenges of accurate assessment in clinical trials. Crit Care [Internet]. 2019 [cited 2026 Jun 12];23:374. Available from: https://doi.org/10.1186/s13054-019-2663-7

15. Fuchs PA, Czech IJ, Krzych ŁJ. Mortality prediction using SOFA score in critically ill surgical and non-surgical patients: which parameter is the most valuable? Medicina (Kaunas) [Internet]. 2020 [cited 2026 Jun 12];56(6):273. Available from: https://doi.org/10.3390/medicina56060273

16. Batassini É, da Silveira JT, Cardoso PC, Castro DE Hochegger T, Vieira DFVB, et al. Nursing Activities Score: what is the ideal periodicity for assessing workload? Acta Paul Enferm [Internet]. 2019 [cited 2026 Jun 12];32(2):162-8. Available from: https://doi.org/10.1590/1982-0194201900023

17. Cao Y, Deng F. Positive pathogens in stool could predict the clinical outcomes of sepsis-associated acute kidney injury in critically ill patient. Sci Rep [Internet]. 2024 [cited 2026 Jun 12];14:11227. Available from: https://doi.org/10.1038/s41598-024-62136-6

18. Innocenti F, Caldi F, Tassinari I, Meo F, Gandini A, Noto P, et al. SOFA score prognostic performance among patients admitted to high-dependency units. Minerva Anestesiol [Internet]. 2019 [cited 2026 Jun 12];85(10):1080-8. Available from: https://doi.org/10.23736/S0375-9393.19.13543-2

19. Coelho FUA, Watanabe M, da Fonseca CD, Padilha KG, Vattimo MFF. Nursing Activities Score and acute kidney injury. Rev Bras Enferm [Internet]. 2017 [cited 2026 Jun 12];70(3):475-80. Available from: https://doi.org/10.1590/0034-7167-2016-0266

20. Ji Y, Li L. Prognostic implications of a cumulative renal score based on both serum creatinine and urine output criteria for staging of acute kidney injury: a cohort study. Int J Gen Med [Internet]. 2021 [cited 2026 Jun 12];14:7833-41. Available from: https://doi.org/10.2147/IJGM.S330002

21. Fan Z, Jiang J, Xiao C, Chen Y, Xia Q, Wang J, et al. Construction and validation of prognostic models in critically ill patients with sepsis-associated acute kidney injury: interpretable machine learning approach. J Transl Med [Internet]. 2023 [cited 2026 Jun 12];21:406. Available from: https://doi.org/10.1186/s12967-023-04205-4

22. Guideli ALS, de Luna LLR, da Silva LFA, Pesavento ML, Nogueira LS, Coelho FUA. Factors associated with nursing workload in patients undergoing extracorporeal membrane oxygenation: a retrospective cohort study. Einstein (Sao Paulo) [Internet]. 2025 [cited 2026 Jun 12];23:eAO1743. Available from: https://doi.org/10.31744/einstein_journal/2025AO1743

23. Ross P, Howard B, Ilic D, Watterson J, Hodgson CL. Nursing workload and patient-focused outcomes in intensive care: a systematic review. Nurs Health Sci [Internet]. 2023 [cited 2026 Jun 12];25(4):497-515. Available from: https://doi.org/10.1111/nhs.13052

24. Elmdni AAE. The impact of nurse-patient ratios on patient outcomes in intensive care units. Nurs Crit Care [Internet]. 2025 [cited 2026 Jun 12];30:e70054. Available from: https://doi.org/10.1111/nicc.70054

25. Hasselgård AM, Stafseth SK, Kirkevold Ø. Nursing workload prediction for upcoming shifts: a retrospective observational exploratory study in the postoperative and intensive care unit. J Nurs Manag [Internet]. 2024 [cited 2026 Jun 12];2024(1):9703289. Available from: https://doi.org/10.1155/2024/9703289

Publicado

03-11-2026

Como Citar

da Silva, K. G. N., Vignoli, Y. R., Santana, B. de S., Abreu, A. F., Inacio, N. da S., & Magro, M. C. da S. (2026). Modelos prognósticos e Nursing Activities Score na avaliação do paciente com injúria renal aguda grave. Cogitare Enfermagem, 31. Recuperado de https://revistas.ufpr.br/cogitare/article/view/101942

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