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将住院总时长分为手术期住院时长和术后住院时长,能改进作为烧伤护理结果质量衡量指标的总体评估。

Division of overall duration of stay into operative stay and postoperative stay improves the overall estimate as a measure of quality of outcome in burn care.

作者信息

Abdelrahman Islam, Elmasry Moustafa, Olofsson Pia, Steinvall Ingrid, Fredrikson Mats, Sjoberg Folke

机构信息

Plastic Surgery Unit, Surgery Department, Suez Canal University, Ismailia, Egypt.

Department of Plastic Surgery, Hand Surgery, and Burns, Linköping University, Linköping, Sweden.

出版信息

PLoS One. 2017 Mar 31;12(3):e0174579. doi: 10.1371/journal.pone.0174579. eCollection 2017.

Abstract

PATIENTS AND METHODS

Surgically managed burn patients admitted between 2010-14 were included. Operative stay was defined as the time from admission until the last operation, postoperative stay as the time from the last operation until discharge. The difference in variation was analysed with F-test. A retrospective review of medical records was done to explore reasons for extended postoperative stay. Multivariable regression was used to assess factors associated with operative stay and postoperative stay.

RESULTS

Operative stay/TBSA% showed less variation than total duration/TBSA% (F test = 2.38, p<0.01). The size of the burn, and the number of operations, were the independent factors that influenced operative stay (R2 0.65). Except for the size of the burn other factors were associated with duration of postoperative stay: wound related, psychological and other medical causes, advanced medical support, and accommodation arrangements before discharge, of which the two last were the most important with an increase of (mean) 12 and 17 days (p<0.001, R2 0.51).

CONCLUSION

Adjusted operative stay showed less variation than total hospital stay and thus can be considered a more accurate outcome measure for surgically managed burns. The size of burn and number of operations are the factors affecting this outcome measure.

摘要

患者与方法

纳入2010年至2014年间接受手术治疗的烧伤患者。手术住院时间定义为从入院至最后一次手术的时间,术后住院时间定义为从最后一次手术至出院的时间。采用F检验分析变异差异。通过回顾病历以探究术后住院时间延长的原因。使用多变量回归评估与手术住院时间和术后住院时间相关的因素。

结果

手术住院时间/烧伤总面积百分比的变异小于总住院时间/烧伤总面积百分比(F检验=2.38,p<0.01)。烧伤面积和手术次数是影响手术住院时间的独立因素(R²=0.65)。除烧伤面积外,其他因素与术后住院时间相关:伤口相关因素、心理因素和其他医疗原因、高级医疗支持以及出院前的住宿安排,其中后两者最为重要,平均延长12天和17天(p<0.001,R²=0.51)。

结论

调整后的手术住院时间变异小于总住院时间,因此可被视为手术治疗烧伤更准确的结局指标。烧伤面积和手术次数是影响该结局指标的因素。

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