title: Ramsay and Richmond's scores are equivalent to assessment sedation level on critical patients.
abstract: OBJECTIVE
  The main purpose of this study was to compare performance of the Ramsay and Richmond sedation scores on mechanically ventilated critically ill patients, in a university-affiliated hospital.
  
  
  METHODS
  This was a 4-month prospective study, which included a total of 45 patients mechanically ventilated, with at least 48 hours stay in the intensive care unit. Each patient was assessed daily for sedation mode, sedative and analgesic doses and sedation level using the Ramsay and Richmond scores. Statistical analysis was made using Student's t-test, Pearson's and Spearman's correlation, and constructing ROC-curves.
  
  
  RESULTS
  A high general mortality of 60% was observed. The length of sedation and daily dose of medication did not correlate with mortality. Deep sedation (Ramsay > 4 or Richmond < -3) was positively correlated with probability of death with an AUC > 0.78. An adequate level of sedation (Ramsay 2 to 4 or Richmond 0 to -3) was sensitively correlated with probability of survival with an AUC > 0.80. A low level of sedation was observed in 63 days evaluated (8.64%), and no correlation was found between occurrence of agitation and unfavorable outcomes. Correlation between Ramsay and Richmond scores (Pearson's > 0.810 - p<0.0001) was good.
  
  
  CONCLUSIONS
  In this study, Ramsay and Richmond sedation scores were similar for the assessment of deep, insufficient and adequate sedation. Both have good correlation with mortality in over sedated patients.
authors.affiliation: Unidade de Terapia Intensiva, Hospital Universitário Lauro Wanderley, João Pessoa, PB, Brasil.
authors.forename: Ciro Leite
authors.initials: CL
authors.lastname: Mendes
authors.affiliation: Clínica Médica, Hospital Universitário Lauro Wanderley, João Pessoa, PB, Brasil.
authors.forename: Lívia Carolina Santos
authors.initials: LC
authors.lastname: Vasconcelos
authors.affiliation: Clínica Médica, Hospital Universitário Lauro Wanderley, João Pessoa, PB, Brasil.
authors.forename: Jordana Soares
authors.initials: JS
authors.lastname: Tavares
authors.affiliation: Clínica Médica, Hospital Universitário Lauro Wanderley, João Pessoa, PB, Brasil.
authors.forename: Silvia Borges
authors.initials: SB
authors.lastname: Fontan
authors.affiliation: Clínica Médica, Hospital Universitário Lauro Wanderley, João Pessoa, PB, Brasil.
authors.forename: Daniela Coelho
authors.initials: DC
authors.lastname: Ferreira
authors.affiliation: Clínica Médica, Hospital Universitário Lauro Wanderley, João Pessoa, PB, Brasil.
authors.forename: Lígia Almeida Carlos
authors.initials: LA
authors.lastname: Diniz
authors.affiliation: Clínica Médica, Hospital Universitário Lauro Wanderley, João Pessoa, PB, Brasil.
authors.forename: Elayne Souza
authors.initials: ES
authors.lastname: Alves
authors.affiliation: Clínica Médica, Hospital Universitário Lauro Wanderley, João Pessoa, PB, Brasil.
authors.forename: Erick José Morais
authors.initials: EJ
authors.lastname: Villar
authors.affiliation: Medicina Intensiva, Hospital Universitário Lauro Wanderley, João Pessoa, PB, Brasil.
authors.forename: César de Farias
authors.initials: Cde F
authors.lastname: Albuquerque
authors.affiliation: Medicina Intensiva, Hospital Universitário Lauro Wanderley, Universidade Federal da Paraíba, João Pessoa, PB, Brasil.
authors.forename: Sérgio Luz Domingues da
authors.initials: SL
authors.lastname: Silva