Gestão da informação como ferramenta para identificação do perfil de pacientes com lesões por pressão em um hospital filantrópico de Belo Horizonte (MG)

Abstract

Introduction: the management of Health Information Systems plays a crucial role in collecting, analyzing, and standardizing data to promote safe and efficient care practices. The lack of integration between systems limits the identification and monitoring of adverse events, such as pressure injuries, which significantly impact care quality and hospital costs. Between 2020 and 2023, over 224,000 pressure injuries were reported in Brazil, with a high prevalence of advanced cases, leading to severe clinical and financial consequences. Objective: to leverage health information systems to analyze the sociodemographic and clinical profiles of hospitalized patients in a 100% publicly funded, large-scale hospital in Belo Horizonte (MG), comparing those who developed pressure injuries with those who did not. Methodology: this quantitative and descriptive study analyzed data from 2020 to 2023, including patients hospitalized for one or more days. Data were extracted from four internal systems: the electronic health record provided clinical and demographic information; the wound dressing dispensation report detailed the consumption and types of dressings used; the nutrition and risk assessment system identified patients at higher risk for pressure injuries; and the incident reporting system recorded adverse events, including pressure injuries. The data, pseudonymized to ensure patient privacy, underwent analysis of sociodemographic, clinical, and dressing consumption variables categorized by injury stage. Analyses were conducted using R software with descriptive and inferential techniques. The study was approved by the Research Ethics Committee (CAAE 74152523.0.0000.5149). Results: among 116,835 patients analyzed, 4.5% developed pressure injuries, with higher prevalence among men (54.7%) and older adults (68%). Patients with injuries experienced significantly longer hospital stays (33.4% remained hospitalized for more than 30 days, compared to 5.7% without injuries) and higher mortality rates (47.7% in severe cases versus 7.0% for patients without injuries). The consumption of specialized dressings was higher among patients with severe injuries (stages 3 and 4), with an average cost of R$223.86 per patient for stage 3 and R$338.31 for stage 4. The COVID-19 pandemic exacerbated these figures, increasing prolonged hospital stays and resource consumption. Among the injuries identified, 11% were formally reported, with delays exceeding 11 days in 11.2% of cases. Patients with severe injuries had the lowest reporting rates, highlighting barriers in manual processes and system integration. As a technical product for the hospital, a data dashboard was developed. Conclusion: the study emphasizes the importance of integrated information systems for optimizing hospital management, reducing the incidence of pressure injuries, and improving patient safety. The fragmentation of systems and lack of standardization in reporting limit data analysis and managerial responsiveness. Therefore, policies aimed at standardization and integration, such as those proposed by the National Health Information and Informatics Policy (PNIIS), are essential to overcome these barriers and strengthen care quality. The development of intelligent systems with predictive algorithms can also contribute to early identification of at-risk patients and more effective preventive interventions. Although the created data dashboard facilitates real-time monitoring of injuries and represents a valuable tool for proactive management, the observed limitations underscore the need for future studies exploring system integration across different types of healthcare services.