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POSTOPERATİF YATIŞ SÜRESİNİN BELİRLEYİCİLERİ

Year 2021, Volume: 7 Issue: 3, 665 - 679, 30.12.2021

Abstract

Bu çalışmada iki kamu hastanesindeki cerrahi hastaların postoperatif yatış süresini etkileyen hastaya, operasyona ve cerraha ait faktörlerin belirlenmesi amaçlanmıştır. 1 Ocak 2017-31 Aralık 2018 tarihleri arasında 6 farklı cerrahi serviste yapılan 5023 cerrahi işleme ilişkin tıbbi kayıtlar retrospektif olarak incelenmiştir. Hastaların postoperatif yatış süresinin belirlenen bağımsız değişkenlere göre farklılık gösterip göstermediği t-testi ve tek yönlü varyans analizi ve postoperatif yatış süresini etkileyen faktörler ise doğrusal regresyon analizi ile test edilmiştir. Hastanelerde yapılan cerrahi işlemlere ilişkin ortalama postoperatif yatış süresi 3,1±3,6 gün olarak bulunmuştur. Hastanın yaşı, preoperatif yatış süresi ve operasyon süresinin artması, cerrahi teknik kullanılmaması, 1. kuşak sefalosporin kullanımı, genel anestezi uygulanması, risk indeksinin 1 ve 2 olması, A3 ve B grubu ve acil bir işlem olması, cerrahi antibiyotik profilaksi süresinin ve seçiminin uygunsuz olması, cerrahın çalışma süresinin 10 yıldan az olması gibi faktörlerin postoperatif yatış süresini artıran bir etkiye sahip olduğu bulunmuştur (p<0,05).

References

  • Angus, D. C., Linde-Zwirble, W. T., Sirio, C. A., Rotondi, A. J., Chelluri, L., Newbold, R. C., et al. (1996). The effect of managed care on ICU length of stay: implications for medicare. Jama, 276(13), 1075-1082.
  • Basques, B. A., Varthi, A. G., Golinvaux, N. S., Bohl, D. D. and Grauer, J. N. (2014). Patient characteristics associated with increased postoperative length of stay and readmission after elective laminectomy for lumbar spinal stenosis. Spine, 39(10), 833-840.
  • Collins, T. C., Daley, J., Henderson, W. H. and Khuri, S. F. (1999). Risk factors for prolonged length of stay after major elective surgery. Annals of surgery, 230(2), 251-259.
  • De la Plaza Llamas, R. and Ramia, J. M. (2020). Cost of postoperative complications: How to avoid calculation errors. World journal of gastroenterology, 26(21), 2682-2690.
  • Demir, C., Celik, Y., Gider, Ö., Yağcı, G., Şahin, B., Tufan, T., et al. (2007). The factors affecting length of stay of the patients undergoing appendectomy surgery in a military teaching hospital. Military Medicine, 172(6), 634-639.
  • Dunn, J. C., Lanzi, J., Kusnezov, N., Bader, J., Waterman, B. R. and Belmont Jr, P. J. (2015). Predictors of length of stay after elective total shoulder arthroplasty in the United States. Journal of Shoulder and Elbow Surgery, 24(5), 754-759.
  • Findlay, J. M. (2010). Canadian health care explained to U.S. colleagues: The good, the bad and the ugly. Can J Neurol Sci, 37, 310-312.
  • Gosain, A. and DiPietro, L. A. (2004). Aging and wound healing. World Journal of Surgery, 28(3), 321-326.
  • Gruskay, J. A., Fu, M., Bohl, D. D., Webb, M. L. and Grauer, J. N. (2015). Factors affecting length of stay after elective posterior lumbar spine surgery: a multivariate analysis. The Spine Journal, 15(6), 1188-1195.
  • Hall, W. B., Willis, L. E., Medvedev, S. and Carson, S. S. (2012). The implications of long-term acute care hospital transfer practices for measures of in-hospital mortality and length of stay. American journal of respiratory and critical care medicine, 185(1), 53-57.
  • Iezzoni, L. I. (1997). Risk adjustment for measuring health care outcomes (Vol. 2). Chicago: Health Administration Press.
  • Luft, H. S. and Hunt, S. S. (1986). Evaluating individual hospital quality through outcome statistics. JAMA, 255, 2780.
  • Meng, Y., Gao, J., Zhang, X. And Zhao, X. (2021). A panel data model of length of stay in hospitals for hip replacements. Econometric Reviews, 40(7), 688-707.
  • Özçetin, M., Saz, E. U., Karapınar, B., Özen, S., Aydemir, Ş. ve Vardar, F. (2009). Hastane enfeksiyonları; sıklığı ve risk faktörleri. J Pediatr Inf, 3(3), 49-53.
  • Powell, R., Scott, N. W., Manyande, A., Bruce, J., Vögele, C., Byrne‐Davis, L. M., et al. (2016). Psychological preparation and postoperative outcomes for adults undergoing surgery under general anaesthesia. Cochrane Database of Systematic Reviews, (5).
  • Rawlinson, A., Kang, P., Evans, J. and Khanna, A. (2011). A systematic review of enhanced recovery protocols in colorectal surgery. The Annals of The Royal College of Surgeons of England, 93(8), 583-588.
  • Yıldırım, A., Torlak, D., Bilgen, Ö. F. ve Yılmazlar, A. (2015). Klinik klavuzların yatış süresi üzerindeki etkinliğinin değerlendirilmesi ve analizi. Sağlık Akademisyenleri Dergisi, 2(4), 180-182.
  • Zhang, S., Huang, Q., Xie, J., Xu, B., Cao, G. and Pei, F. (2018). Factors influencing postoperative length of stay in an enhanced recovery after surgery program for primary total knee arthroplasty. Journal of Orthopaedic Surgery and Research, 13(1), 1-7.

DETERMINANTS OF POSTOPERATIVE LENGHT OF STAY

Year 2021, Volume: 7 Issue: 3, 665 - 679, 30.12.2021

Abstract

In this study, it was aimed to determine the factors related to the patient, the operation and the surgeon that affect the postoperative length of stay of surgical patients in two public hospitals. Medical records of 5023 surgical procedures performed in 6 different surgical services between January 1, 2017 and December 31, 2018 were reviewed retrospectively. Whether the postoperative lenght of stay of the patients differed according to the determined independent variables was tested with the t-test and one-way analysis of variance, and the factors affecting the postoperative lenght of stay were tested with linear regression analysis. The mean postoperative lenght of stay for surgical procedures performed in hospitals was found to be 3.1±3.6 days. Age of the patient, increase in preoperative hospitalization and operation time, not using surgical technique, use of 1st generation cephalosporin, administration of general anesthesia, risk index 1 and 2, A3 and B group and an emergency procedure, inappropriate duration and choice of surgical antibiotic prophylaxis It was found that factors such as the surgeon's working time less than 10 years had an effect on increasing the postoperative lenght of stay (p<0.05).

References

  • Angus, D. C., Linde-Zwirble, W. T., Sirio, C. A., Rotondi, A. J., Chelluri, L., Newbold, R. C., et al. (1996). The effect of managed care on ICU length of stay: implications for medicare. Jama, 276(13), 1075-1082.
  • Basques, B. A., Varthi, A. G., Golinvaux, N. S., Bohl, D. D. and Grauer, J. N. (2014). Patient characteristics associated with increased postoperative length of stay and readmission after elective laminectomy for lumbar spinal stenosis. Spine, 39(10), 833-840.
  • Collins, T. C., Daley, J., Henderson, W. H. and Khuri, S. F. (1999). Risk factors for prolonged length of stay after major elective surgery. Annals of surgery, 230(2), 251-259.
  • De la Plaza Llamas, R. and Ramia, J. M. (2020). Cost of postoperative complications: How to avoid calculation errors. World journal of gastroenterology, 26(21), 2682-2690.
  • Demir, C., Celik, Y., Gider, Ö., Yağcı, G., Şahin, B., Tufan, T., et al. (2007). The factors affecting length of stay of the patients undergoing appendectomy surgery in a military teaching hospital. Military Medicine, 172(6), 634-639.
  • Dunn, J. C., Lanzi, J., Kusnezov, N., Bader, J., Waterman, B. R. and Belmont Jr, P. J. (2015). Predictors of length of stay after elective total shoulder arthroplasty in the United States. Journal of Shoulder and Elbow Surgery, 24(5), 754-759.
  • Findlay, J. M. (2010). Canadian health care explained to U.S. colleagues: The good, the bad and the ugly. Can J Neurol Sci, 37, 310-312.
  • Gosain, A. and DiPietro, L. A. (2004). Aging and wound healing. World Journal of Surgery, 28(3), 321-326.
  • Gruskay, J. A., Fu, M., Bohl, D. D., Webb, M. L. and Grauer, J. N. (2015). Factors affecting length of stay after elective posterior lumbar spine surgery: a multivariate analysis. The Spine Journal, 15(6), 1188-1195.
  • Hall, W. B., Willis, L. E., Medvedev, S. and Carson, S. S. (2012). The implications of long-term acute care hospital transfer practices for measures of in-hospital mortality and length of stay. American journal of respiratory and critical care medicine, 185(1), 53-57.
  • Iezzoni, L. I. (1997). Risk adjustment for measuring health care outcomes (Vol. 2). Chicago: Health Administration Press.
  • Luft, H. S. and Hunt, S. S. (1986). Evaluating individual hospital quality through outcome statistics. JAMA, 255, 2780.
  • Meng, Y., Gao, J., Zhang, X. And Zhao, X. (2021). A panel data model of length of stay in hospitals for hip replacements. Econometric Reviews, 40(7), 688-707.
  • Özçetin, M., Saz, E. U., Karapınar, B., Özen, S., Aydemir, Ş. ve Vardar, F. (2009). Hastane enfeksiyonları; sıklığı ve risk faktörleri. J Pediatr Inf, 3(3), 49-53.
  • Powell, R., Scott, N. W., Manyande, A., Bruce, J., Vögele, C., Byrne‐Davis, L. M., et al. (2016). Psychological preparation and postoperative outcomes for adults undergoing surgery under general anaesthesia. Cochrane Database of Systematic Reviews, (5).
  • Rawlinson, A., Kang, P., Evans, J. and Khanna, A. (2011). A systematic review of enhanced recovery protocols in colorectal surgery. The Annals of The Royal College of Surgeons of England, 93(8), 583-588.
  • Yıldırım, A., Torlak, D., Bilgen, Ö. F. ve Yılmazlar, A. (2015). Klinik klavuzların yatış süresi üzerindeki etkinliğinin değerlendirilmesi ve analizi. Sağlık Akademisyenleri Dergisi, 2(4), 180-182.
  • Zhang, S., Huang, Q., Xie, J., Xu, B., Cao, G. and Pei, F. (2018). Factors influencing postoperative length of stay in an enhanced recovery after surgery program for primary total knee arthroplasty. Journal of Orthopaedic Surgery and Research, 13(1), 1-7.
There are 18 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Aysun Kandemir Türe 0000-0002-3496-5594

Bayram Şahin This is me 0000-0003-2772-3033

Publication Date December 30, 2021
Acceptance Date December 20, 2021
Published in Issue Year 2021 Volume: 7 Issue: 3

Cite

APA Kandemir Türe, A., & Şahin, B. (2021). POSTOPERATİF YATIŞ SÜRESİNİN BELİRLEYİCİLERİ. Uluslararası Sağlık Yönetimi Ve Stratejileri Araştırma Dergisi, 7(3), 665-679.
AMA Kandemir Türe A, Şahin B. POSTOPERATİF YATIŞ SÜRESİNİN BELİRLEYİCİLERİ. USAYSAD. December 2021;7(3):665-679.
Chicago Kandemir Türe, Aysun, and Bayram Şahin. “POSTOPERATİF YATIŞ SÜRESİNİN BELİRLEYİCİLERİ”. Uluslararası Sağlık Yönetimi Ve Stratejileri Araştırma Dergisi 7, no. 3 (December 2021): 665-79.
EndNote Kandemir Türe A, Şahin B (December 1, 2021) POSTOPERATİF YATIŞ SÜRESİNİN BELİRLEYİCİLERİ. Uluslararası Sağlık Yönetimi ve Stratejileri Araştırma Dergisi 7 3 665–679.
IEEE A. Kandemir Türe and B. Şahin, “POSTOPERATİF YATIŞ SÜRESİNİN BELİRLEYİCİLERİ”, USAYSAD, vol. 7, no. 3, pp. 665–679, 2021.
ISNAD Kandemir Türe, Aysun - Şahin, Bayram. “POSTOPERATİF YATIŞ SÜRESİNİN BELİRLEYİCİLERİ”. Uluslararası Sağlık Yönetimi ve Stratejileri Araştırma Dergisi 7/3 (December 2021), 665-679.
JAMA Kandemir Türe A, Şahin B. POSTOPERATİF YATIŞ SÜRESİNİN BELİRLEYİCİLERİ. USAYSAD. 2021;7:665–679.
MLA Kandemir Türe, Aysun and Bayram Şahin. “POSTOPERATİF YATIŞ SÜRESİNİN BELİRLEYİCİLERİ”. Uluslararası Sağlık Yönetimi Ve Stratejileri Araştırma Dergisi, vol. 7, no. 3, 2021, pp. 665-79.
Vancouver Kandemir Türe A, Şahin B. POSTOPERATİF YATIŞ SÜRESİNİN BELİRLEYİCİLERİ. USAYSAD. 2021;7(3):665-79.