Concordância entre avaliadores sobre a classificação de flebite, seus sinais e sintomas em cateteres intravenosos periféricos
Resumo
Objetivo: O objetivo deste estudo foi determinar a concordância entre avaliadores da classificação da flebite, seus sinais e sintomas usando a Escala Visual de Flebite por Infusão.
Métodos: Estudo de coorte prospectivo em pacientes maiores de 18 anos internados em serviço de emergência, com o primeiro cateter venoso periférico instalado. Os sinais e sintomas de flebite foram avaliados diariamente usando a escala VIP. Foi realizada uma análise descritiva e calculada a concordância da classificação da flebite, seus sinais e sintomas, utilizando o coeficiente Kappa de Cohen.
Resultados: 817 pacientes foram incluídos. O sinal ou sintoma mais frequente foi eritema (13,59%), seguido de dor (11,50%), edema (2,99%) e enduração (2,02%), não havendo cordão venoso palpável nem pirexia. A incidência geral de flebite foi de 11,44%; grau II (9,42%) e grau III (2,02%). O coeficiente Kappa de Cohen foi de 0,990 (IC 95% 0,982 - 0,996) para a classificação geral de flebite. A maior reprodutibilidade para sinais e sintomas foi para dor (k=0,946), seguida por endurecimento (k=0,894), edema (k=0,716) e eritema (k=0,649).
Conclusões: Este estudo mostrou alta concordância entre avaliadores para a escala em geral e concordância de boa a muito boa para cada um dos sinais e sintomas. Pesquisas futuras devem avaliar se purulência e pirexia são sinais úteis para triagem e identificação precoce de flebite.
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