Banca de DEFESA: ISABELLE CAMPOS DE AZEVEDO

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
DISCENTE : ISABELLE CAMPOS DE AZEVEDO
DATA : 13/12/2016
HORA: 14:00
LOCAL: Departamento de Enfermagem
TÍTULO:

CLINICAL AND EPIDEMIOLOGICAL PROFILE AND SURVIVAL OF PATIENTS TRANSPLANTED WITH HEMATOPOIETIC STEM CELLS IN A REFERENCE SERVICE IN RIO GRANDE DO NORTE

PALAVRAS-CHAVES:

Hematopoietic Stem Cell Transplantation, Bone Marrow Transplantation; Epidemiology, Delivery of Health Care.

PÁGINAS: 100
GRANDE ÁREA: Ciências da Saúde
ÁREA: Enfermagem
RESUMO:

The Stem Cell Transplantation Hematopoietic (HSCT) has been used as an alternative and effective therapy for patients with oncological diseases, hematological or immunological, malignant or not, inherited or acquired. The HSCT may occur through autologous transplantation, wherein the Cells Hematopoietic Progenitor (CHP) is collected from peripheral blood or bone marrow of the patient; allogeneic to which the donor is related or not with Human Leukocyte Antigens (HLA) the CHP and from peripheral blood, bone marrow, umbilical cord blood or placental; or syngeneic, when the donor is identical twin. This study aimed to characterize the clinical and epidemiological profile of patients who underwent HSCT in a reference service in the state of Rio Grande do Norte and estimate the overall survival of transplant patients. Is a study of retrospective cohort study with a quantitative, descriptive and analytical approach performed by collecting data from medical records of patients who underwent HSCT in a reference service in the state of Rio Grande do Norte (RN) between January 2008 and December 2015. data were collected between March and September 2016 at the Medical Archive and Statistics Service (MASS), and included analysis of recorded medical records of 272 patients who underwent HSCT in the service in question. sample were excluded 11 records that were not found. For data collection it was used an instrument that addressed the socio-demographic and clinical data of patients. Data were organized in Microsoft Excel® 2010 spreadsheet program to procedures descriptive and inferential analysis. For descriptive analysis of the data we used the Epi Info 2002 program, version 3.5.2. For a description of the sample tables were constructed containing the absolute and relative frequencies by gender and total averages and standard deviations. To calculate the likelihood of association between the characteristics analyzed and sex were used the chi-square trend, Fisher's exact test and the Mann Whitney test, according to each case. The survival estimates were calculated using the Kaplan-Meier method, when it was considered the starting point of patient entry into the study to date of the HSCT and end the last event: death, abandonment or monitoring at the time of data collection. To compare the survival rates for variables to be listed was used the statistical method of Log Rank. The survival calculations were performed using SPSS (Statistic Package for Social Sciences) version 22.0. The significance level was 0.05. The research protocol was submitted to the Research Ethics Committee (REC) of the Federal University of Rio Grande do Norte (UFRN), in accordance with Resolution no. 466/12 of the National Health Council (NHC) of the Ministry of Health, which deals with the research on human subjects to assess their ethical and methodological aspects. It was approved on July 1, 2015, in the opinion 1,132,720 and CAAE: 46202715.7.0000.5537. From the data analysis, it was observed that of the 272 patients, 53.3% were male, 46.7% were married, with an average age of 38.7 years, 78.3% lived in NB and 15% were students. Regarding the situation with HSCT service, 67.6% had completed treatment, the mean follow-up was seven months, the average time between the start of monitoring to HSCT was two months and overall survival was on average four months. As for the diagnosis leading to the HSCT, 23.5% of the patients had multiple myeloma and more antineoplastic therapies were used (100.0%), antibiotics (96.7%), antiemetics (97%), antifungals (94, 8%), antimicrobials (94.1%), proton pump inhibitors / anti-ulcer (94.4%), antivirals (91.5%), amino acids (84.9%), analgesics / antipyretics (86.4% ), antihistamine (86.4%), corticosteroids (86%), and blood therapy (84.5%). Among the comorbidities / toxicities that occurred more are the gastroenterological (93%), fever (68%), cardiovascular (53.7%), hematologic (48.1%) and respiratory (47.8%). Regarding the type of transplant, allogeneic was performed in 54.8% of patients, most MHC source used was peripheral blood (77.9%) and, among allogeneic transplants, the congener was performed in 71, 8% of cases. Among patients 9.9% had more than one HSCT and 4% had to graft versus host disease. Regarding the causes of deaths, septic shock appeared in 5.5% of cases, followed by sepsis (4.8%), multiple organ failure (4.8%) and lung infection (4%). The data presented demonstrated the epidemiological profile of patients treated with HSCT in an RN reference institution. These certainly will inform decision-making regarding the care provided in the context of HSCT. Therefore, we consider the importance of further studies on the subject in order to trace the different demographic and epidemiological profile of the Brazilian regions with regard to HSCT as a therapeutic.

MEMBROS DA BANCA:
Presidente - 1352508 - MARCOS ANTONIO FERREIRA JUNIOR
Interno - 1552864 - ALLYNE FORTES VITOR
Interno - 1220598 - VIVIANE EUZEBIA PEREIRA SANTOS
Externo à Instituição - MARIA LÚCIA IVO - UFMS