剖宫产术后女性住院时间的相关因素。
Factors associated with the length of hospital stay of women undergoing cesarean section.
作者信息
Pereira Samire Lopes, Silva Thales Philipe Rodrigues da, Moreira Alexandra Dias, Novaes Taiane Gonçalves, Pessoa Milene Cristine, Matozinhos Isabela Penido, Couto Renato Camargo, Pedrosa Tânia Moreira Grillo, Matozinhos Fernanda Penido
机构信息
Universidade Federal de Minas Gerais . Escola de Enfermagem . Curso de Especialização em Enfermagem Obstétrica - modalidade residência. Belo Horizonte , MG , Brasil.
Universidade Federal de Minas Gerais . Faculdade de Medicina . Programa de Pós-Graduação em Ciências da Saúde . Belo Horizonte , MG , Brasil.
出版信息
Rev Saude Publica. 2019 Sep 2;53:65. doi: 10.11606/s1518-8787.2019053001113.
OBJECTIVE
To evaluate whether age group, complications or comorbidities are associated with the length of hospitalization of women undergoing cesarean section.
METHODS
A cross-sectional study was carried out between June 2012 and July 2017, with 64,437 women undergoing cesarean section and who did not acquire conditions during their hospital stay. Hospital discharge data were collected from national health institutions, using the Diagnosis-Related Groups system (DRG Brasil®). The DRG referring to cesarean section with additional complications or comorbidities (DRG 765) and cesarean section without complications or associated comorbidities (DRG 766) were included in the initial diagnosis. The influence of age group and comorbidities or complications present at admission on the length of hospital stay was assessed based on the means of the analysis of variance. The size of the effect was verified by Cohen's D, which allows evaluating clinical relevance. The criticality levels were identified using the Duncan test.
RESULTS
The longest length of hospital stay was observed in the age group from 15 to 17 years old and among those aged 45 years old or more. The hospital stay of women with complications or comorbidities at the time of admission was also longer. Moreover, it was noted that the increase in criticality level was associated with an increase in the mean length of hospital stay.
CONCLUSIONS
The length of hospital stay of women is higher among those belonging to the age group ranging from 15 to 17 years old and for those aged 45 years old or more. The presence of associated comorbidities, such as eclampsia, pre-existing hypertensive disorder with superimposed proteinuria and gestational hypertension (induced by pregnancy) with significant proteinuria increase the length of hospital stay. This study enabled the construction of distinct criticality level profiles based on the combination of age groups and the main comorbidities, which were directly related to the length of hospital stay.
目的
评估年龄组、并发症或合并症是否与剖宫产妇女的住院时间相关。
方法
于2012年6月至2017年7月进行了一项横断面研究，纳入64437例剖宫产妇女，且她们在住院期间未出现其他病症。使用诊断相关分组系统（DRG Brasil®）从国家卫生机构收集医院出院数据。初步诊断纳入了伴有其他并发症或合并症的剖宫产相关诊断相关分组（DRG 765）以及无并发症或合并症的剖宫产相关诊断相关分组（DRG 766）。基于方差分析方法评估年龄组以及入院时存在的合并症或并发症对住院时间的影响。通过科恩D值验证效应大小，其可用于评估临床相关性。使用邓肯检验确定临界水平。
结果
观察到15至17岁年龄组以及45岁及以上年龄组的住院时间最长。入院时伴有并发症或合并症的妇女住院时间也更长。此外，还注意到临界水平的增加与平均住院时间的增加相关。
结论
15至17岁年龄组以及45岁及以上年龄组的妇女住院时间更长。子痫、既往高血压疾病合并蛋白尿以及妊娠高血压（妊娠诱发）合并大量蛋白尿等合并症的存在会增加住院时间。本研究基于年龄组和主要合并症的组合构建了不同的临界水平概况，这些与住院时间直接相关。
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