Mariam Tesfamichael G, Abate Addisu Taye, Getnet Mehammed Adem
School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Surg Res Pract. 2019 Jul 28;2019:6417240. doi: 10.1155/2019/6417240. eCollection 2019.
Intestinal obstruction (IO) is one of the most common acute abdominal disorders that often requires emergency surgical management in the hospital setting. However, the surgical management sometimes ends with unfavorable outcomes characterized by fatal and nonfatal postoperative complications.
The aim of this study was to analyze the surgical management outcome of IO and its associated factors among surgically treated patients for intestinal obstruction at the University of Gondar Comprehensive Specialized Hospital (UGCSH), Ethiopia, 2018.
An institution-based cross-sectional study was conducted among patients who were surgically treated for IO during the last 3 years at the UGCSH. The patient participants were selected using a systematic random sampling technique. A structured research tool was used to collect all the necessary data from the patients' medical records. The data were analyzed by using SPSS version 21. Frequencies with percentages were used to describe the surgical management outcome of IO. The binary logistic regression model was used to explore the determinant factors associated with the surgical management outcome of IO. Factors at < 0.05 were declared statically significant.
227 patient participants were included and finally analyzed in this study. From these, 83.3% patients have favorable surgical management outcomes of IO, whereas the rest 16.7% patients have unfavorable outcomes. Of 38 patients with unfavorable outcome, the most common postoperative complication occurred was surgical site infection (36.8%), followed by pneumonia (23.6%) and septic shock (21.0%) among other complications. A total of 10 postoperative deaths were also documented as unfavorable surgical management outcomes of IO. Of the determinant factors analyzed in this study, only three factors, duration of illness before surgery, length of hospital stay after surgery, and comorbidity, were independently significantly associated with the surgical management outcome of IO.
In this study, the majority of patients had favorable surgical management outcomes of IO, and the proportion of patients with unfavorable outcomes was however considerable. Thus, designing a strategy addressing the significantly associated determining factors could be helpful to further increase the likelihood of favorable surgical management outcomes of IO.
肠梗阻(IO)是最常见的急性腹部疾病之一,在医院环境中通常需要紧急手术治疗。然而,手术治疗有时会以不良结局告终,其特征为致命和非致命的术后并发症。
本研究的目的是分析2018年在埃塞俄比亚贡德尔大学综合专科医院(UGCSH)接受手术治疗的肠梗阻患者的手术治疗结局及其相关因素。
在UGCSH对过去3年接受IO手术治疗的患者进行了一项基于机构的横断面研究。采用系统随机抽样技术选择患者参与者。使用结构化研究工具从患者病历中收集所有必要数据。使用SPSS 21版进行数据分析。频率和百分比用于描述IO的手术治疗结局。二元逻辑回归模型用于探索与IO手术治疗结局相关的决定因素。P<0.05的因素被认为具有统计学意义。
本研究共纳入227例患者参与者并进行最终分析。其中,83.3%的患者IO手术治疗结局良好,其余16.7%的患者结局不佳。在38例结局不佳的患者中,最常见的术后并发症是手术部位感染(36.8%),其次是肺炎(23.6%)和感染性休克(21.0%)以及其他并发症。共有10例术后死亡也被记录为IO手术治疗的不良结局。在本研究分析的决定因素中,只有三个因素,即术前患病时间、术后住院时间和合并症,与IO的手术治疗结局独立显著相关。
在本研究中,大多数患者IO手术治疗结局良好,但结局不佳的患者比例也相当可观。因此,设计一种针对显著相关决定因素的策略可能有助于进一步提高IO手术治疗良好结局的可能性。