PERFIL EPIDEMIOLÓGICO DE PACIENTES SUBMETIDOS À CIRURGIA CARDÍACA EPIDEMIOLOGICAL PROFILE OF PATIENTS SUBMITTED TO CARDIAC SURGERY PERFIL EPIDEMIOLÓGICO DE PACIENTES SOMETIDOS A LA CIRUGÍA CARDÍACA

Objective: to describe the sociodemographic and clinical profile of patients undergoing cardiac surgery. Method: this is a quantitative, cross-sectional and descriptive study carried out in a university hospital. The sample was composed of 200 patients submitted to cardiac surgery. The data was collected by means of a specific form, of secondary data contained in the medical records. The Microsoft Office Excel program, version 2010 was used for the tabulation and the data was analyzed by the Stata 14.0 statistical program. The results were presented in the table. Results: the medical records of 200 patients submitted to cardiac surgery were evaluated, and of these, the majority were male, composed of patients older than 60 years and pardos, systemic arterial hypertension, dyslipidemia and Diabetes Mellitus being the most common comorbidities prevalent. The main complications were identified as pulmonary and cardiac arrhythmias. Conclusion: it is possible, based on the knowledge about the profile of the patients that underwent cardiac surgery, to expand educational and health prevention actions, subsidizing strategies for adherence to treatment and control of complications. Descriptors: Length of hospitalization; Cardiovascular Surgical Procedures; Health Profile; Health Regulation and Surveillance; Thoracic Surgery; Nursing. RESUMEN Objetivo: describir el perfil sociodemográfico y clínico de los pacientes sometidos a la cirugía cardiaca. Método: se trata de un estudio cuantitativo, transversal y descriptivo, realizado en un hospital universitario. Se compuso la muestra por 200 pacientes sometidos a la cirugía cardiaca. Se recolectaron los datos a través de un formulario específico, de datos secundarios contenidos en los prontuarios. Se utilizaron para la tabulación el programa Microsoft Office Excel, versión 2010 y se analizaron los datos por el programa estadístico Stata 14.0. Se presentaron los resultados en tabla. Resultados: se evaluaron los prontuarios de 200 pacientes sometidos a la cirugía cardiaca y, de éstos, la mayor parte era del sexo masculino, compuesta por mayores de 60 años y pardos, siendo la hipertensión arterial sistémica, la dislipidemia y la Diabetes Mellitus las comorbilidades más prevalente. Se identificaron, como las principales complicaciones, las pulmonares y las arritmias cardíacas. Conclusión: se permite, a partir del conocimiento acerca del perfil de los pacientes que realizaron cirugía cardiaca, ampliar las acciones educativas y de prevención a la salud, subsidiando estrategias para la adhesión al tratamiento y al control de las complicaciones. Descriptores: Tiempo de internación; Procedimientos Quirúrgicos Cardiovasculares; Perfil de Salud; Regulación y Fiscalización em salud; Cirugía Torácica; Enfermería. Mestre, Hospital Cassiano Antônio de Morais/HUCAM. Vitória (ES), Brasil. E-mail: morgzinha@hotmail.com ORCID iD: http://orcid.org/0000-0002-2642-531X; Doutoras, Universidade Federal do Espirito Santo/UFES. Vitória (ES), Brasil. E-mail: elianelima66@gmail.com ORCID iD: http://orcid.org/0000-0001-5128-3715; E-mail: ritainesc@gmail.com ORCID iD: http://orcid.org/0000-00018289-9117; E-mail:mirianfioresi@hotmail.com ORCID iD: http://orcid.org/0000-0002-85604385; E-mail: francielemarabotti@gmail.com ORCID iD: http://orcid.org/0000-0002-6171-6972; E-mail: candidaprimoi@gmail.com ORCID iD: http://orcid.org/0000-0001-5141-2898 ARTIGO ORIGINAL Reis MMR, Lima EFA, Casagrande RI et al. Perfil epidemiológico de pacientes submetidos...

English/Portuguese J Nurs UFPE online., Recife, 13(4):1015-22, Apr., 2019  1016 Cardiovascular diseases (CVD) are a major challenge for contemporary societies, especially as they are a frequent cause of morbidity and mortality, 1 revealing a public health problem and one of the universal reasons for hospitalization. 2 It is known that in Brazil, CVD are among the main indicators of incidence and prevalence in the Unified Health System (UHS), and despite the reduction in mortality in recent years, these diseases accounted for 30.4% of deaths in 2011. 3 2014, there were 1,140,792 hospitalizations due to diseases of the circulatory system in the UHS, with an overall cost of R$2,616,411,987.59, and in the Southeast region, 505,092 hospitalizations occurred and the total amount spent was R$1,221,847,218.82;already, in Espírito Santo, there were 24,484 hospitalizations, with a total cost of R$48,855,697.28. 4 It is explained that the therapeutic approach of cardiovascular diseases can be clinical or surgical, both with the objective of restoring the functional capacity of the heart in order to reduce the symptomatology and to return the individual to their normal activities. 5Alert that cardiac surgeries are large surgeries, worldwide, but indicated when the probability of survival is greater with the surgical treatment than with the clinical treatment. 6 is understood that the clinical comorbidities associated with cardiac surgery patients, the complexity of the surgical intervention, the need for intensive care unit (ICU) hospitalization in some cases, postoperative complications, infections and even the issues social factors are factors that can prolong hospital stay. It is important, in this sense, to know the socio-demographic and clinical profile of patients submitted to cardiac surgery and who use the hospital beds, since it can contribute to the improvement of the management of this resource in the institution, through an adequate planning, in relation to the allocation of health resources, currently reduced in response to demand, mainly in the UHS.
• To describe the sociodemographic and clinical profile of patients undergoing cardiac surgery.The following sources of data were collected: charts of patients undergoing cardiac surgery, bank records of the cardiac surgery team and the management application for university hospitals.

It
After the data collection, this information was coded and revised by the researcher, and they were subsequently typed into a spreadsheet in the Microsoft Office® Excel 2010 program and analyzed by the statistical program Stata 14.0.It is described, regarding the sociodemographic characteristics, that among the 200 patients evaluated.Individuals married or in a stable union were considered as partners, and the individuals who were currently working, whether salaried or selfemployed, were considered as occupations; the retirees, the home and the unemployed were characterized as without occupation.Table 3 details the procedures performed by the patients submitted to cardiac surgery and the duration of the surgeries.These values were adopted for the duration of surgery and the value of ECT because they are the median values of the duration of surgery and duration of ECT in the surgical procedures collected, since there is no reference to be used for these purposes in previous studies.The profile of complications in the trans and postoperative period of patients undergoing surgery was shown in table 4. The sociodemographic and clinical profile of patients submitted to cardiac surgery observed in this study is in line with the results of other national studies.It was observed a cross-sectional study carried out in São Paulo, involving 100 patients submitted to cardiac surgery.Among the patients, the male gender (56.0%), aged between 50 and 70 years (67.0% ) and mean of 58.7 (SD = 10.5).Previous diseases such as systemic arterial hypertension, Diabetes Mellitus type 2 and dyslipidemia were more frequent, and the most frequently performed surgery was myocardial revascularization (MR) (58.0%), with complications, atrial fibrillation was highlighted, and 93% were elective in terms of surgical status. 11he majority of the population was composed of elderly men, who were in the metropolitan area of the State and had no occupation, in the same way as the study performed with patients undergoing coronary artery bypass surgery in 2017, showing a masculine and senile population .It is also possible to relate the origin of the metropolitan region, that is, in the vicinity of the hospital institution, to facilitate access to highly complex health services. 5e majority of the patients were hospitalized in the study, but on the other hand, a portion had, as an entrance, the emergency and emergency department of the institution, often being diagnosed and treated an AMI prior to surgery cardiac.It was identified, in a study carried out in Florianópolis, that verified the access to health services by patients submitted to cardiac surgery, which the hospital search for, in cases of health intercurrences, was related to the difficulty in accessing the consultations with the general practitioner in primary care and specialist in medium complexity. 5 was observed in most cases that postoperative MV time was greater than 12 hours and surgery time was up to 270 minutes.In another study, similarity between these times was found, with an average time of surgery of 253 minutes, and the invasive ventilatory strategy lasted for a median time of 870 minutes, that is, 14.5 hours. 2 In another study, surgery times of 202 minutes and MV of 608.4 minutes were found, that is, approximately ten hours. 12rdiac surgery of the extracorporeal circulation is needed in most cases, since it is a long-term procedure.By the evolution and development of CPB, complex cardiovascular pathologies were surgically treated, and what was previously inoperable and meant a sentence of poor quality of life or even short

DISCUSSION
English/Portuguese J Nurs UFPE online., Recife, 13(4):1015-22, Apr., 2019 1021 duration of life became a solution to many problems in the area of Cardiology. 13owever, it is pointed out in other studies that this technique provokes a systemic inflammatory response with the release of substances that impair coagulation and the autoimmune system. 9,14 is advised that, during the cardiac transoperative period, as a result of ECC and cardiac arrest, the patient will need an artificial ventilatory support, 15 which causes changes in the patient's cardiovascular hemodynamics and causes a decrease in renal blood flow. 2 Know As for the postoperative period, the patient undergoing cardiac surgery will remain in the MV until full lucidity is recovered, and the nurse's attention is necessary in monitoring vital signs, clearing the airways and keeping the head high. 7,10lmonary complications were among the most common among patients undergoing cardiac surgery, as well as cardiac arrhythmias.The main complications include ventilatory and respiratory changes due to anesthesia, surgical procedures and extracorporeal circulation, as well as preoperative factors such as pulmonary diseases and previous respiratory conditions. 15 was confirmed that the most frequent postoperative complications were respiratory and hemodynamic complications, with a higher incidence of MRS between the first postoperative days. 12There was also a greater frequency of pulmonary complications in 64.6% of patients in the postoperative period of cardiac surgery. 16 was also identified in another study that the most frequent complication among patients in the postoperative period of cardiac surgery was arrhythmia, specifically atrial fibrillation, and is related to some comorbidities. 2 It is reported that, in relation to the use of vasoactive drugs, the majority of patients used these medications postoperatively, because, due to hemodynamic instability that may occur in the immediate postoperative period, the patient may need vasoactive drugs and remain in the ICU for as long as.7 It was determined, in a study analyzing the clinical characteristics of patients submitted to cardiac surgery, that the use of AVD was present in 45.8% of the patients who underwent coronary artery bypass surgery.16 It is stated that the mortality in the study was equivalent to 9.5%, similar to the retrospective study carried out in Rio de Janeiro in 2011, in which a mortality rate of 8.89% was observed.17 Some limitations were observed, since it is a retrospective study and with secondary data, in the form of obtaining the data, the completeness of the data, as well as the quality of the information; despite this limitation, this study was able to reach pertinent discussions about the characterization of patients submitted to cardiac surgery, as well as to encourage and strengthen the regulation and bed management culture, beginning the change of practices and concepts in this institution.
This study allowed us to know the epidemiological profile of patients who underwent cardiac surgery in a university hospital in cardiology and cardiac surgery, through cross-sectional research.For this data, we can help develop strategies at the hospital and outpatient level to improve care for this clientele.
Clinical and sociodemographic variables compatible with other national studies in this area were identified.
This study emphasizes the importance of knowing the profile of patients who underwent cardiac surgery at the institution to contribute to the intensification of educational actions and prevention of health, subsidizing strategies for adherence to treatment and control of complications.It is also observed the need for new studies to examine the association between length of hospital stay and sociodemographic and clinical variables of patients undergoing cardiac surgery.

Table 1
also shows data related to preoperative clinical characteristics.

Table 1 .
Sociodemographic and clinical characterization of patients submitted to cardiac surgery.Universitary hospital.

Table 4 .
Profile of trans and postoperative complications of patients submitted to surgery.Universitary hospital.