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临床结局和预测因素在埃塞俄比亚肠梗阻手术:一项横断面研究。

Clinical Outcome and Predictors of Intestinal Obstruction Surgery in Ethiopia: A Cross-Sectional Study.

机构信息

Department of Obstetrics and Gynecology, College of Medicine and Health Science, Harar, Ethiopia.

School of Public Health, College of Medicine and Health Sciences, Haramaya University, Harar, Ethiopia.

出版信息

Biomed Res Int. 2020 Nov 23;2020:7826519. doi: 10.1155/2020/7826519. eCollection 2020.

Abstract

BACKGROUND

Despite the advancement in the healthcare system, the impact of surgical interventions on public health systems will continue to grow. But predicting the outcome is challenging. Concerns related to unexpected outcomes and delays in the diagnosis of postoperative complications are the major issue. Intestinal obstruction is a common life-threatening surgical condition followed by fatal and nonfatal postoperative complications. This study was aimed at assessing results after surgery for intestinal obstruction in a hospital of Ethiopia. . An institutional-based cross-sectional study was conducted among 254 postoperative patients admitted with intestinal obstruction from January 1, 2014, to December 31, 2017. Data were coded and entered into EpiData 4.2.0.0 software and exported to the Statistical Package for the Social Sciences version 22 for analysis. A binary logistic regression model was used for analysis. All variables with a value < 0.25 during bivariable analysis were considered for multivariable logistic regression analysis.

RESULTS

The magnitude of poor surgical outcome of intestinal obstruction was 21.3% for patients enrolled into this investigation. The age group of ≥55 years (adjusted odds ratio (AOR) = 2.9, 95% CI: 1.03, 8.4), duration of illness of ≥24 hrs (AOR = 3.1, 95% CI: 1.03, 9.4), preoperative diagnosis of a gangrenous large bowel (AOR = 3.6, 95% CI: 1.3, 9.8), and a gangrenous small bowel (AOR = 4.2, 95% CI: 1.3, 13.7) were significantly associated with poor surgical outcome.

CONCLUSIONS

The magnitude of poor surgical outcome was high. Age, late presentation of illness, and gangrenous bowel obstructions were significantly associated with poor outcomes. So, concern should be given in early detection and follow-up of patients who came late and older patients.

摘要

背景

尽管医疗保健系统取得了进步,但手术干预对公共卫生系统的影响仍将继续增长。但预测结果具有挑战性。与意外结果和术后并发症诊断延迟相关的问题是主要问题。肠梗阻是一种常见的危及生命的手术情况,其后是致命和非致命的术后并发症。本研究旨在评估埃塞俄比亚一家医院肠梗阻手术后的结果。这是一项在 2014 年 1 月 1 日至 2017 年 12 月 31 日期间因肠梗阻入院的 254 例术后患者中进行的基于机构的横断面研究。数据进行编码并输入 EpiData 4.2.0.0 软件,然后导出到统计软件包 22 进行分析。使用二元逻辑回归模型进行分析。在单变量分析中 值<0.25 的所有变量都被认为适合多变量逻辑回归分析。

结果

本研究中,肠梗阻患者的手术不良结局发生率为 21.3%。年龄≥55 岁组(校正优势比(AOR)=2.9,95%置信区间:1.03,8.4)、疾病持续时间≥24 小时组(AOR=3.1,95%置信区间:1.03,9.4)、术前诊断为坏疽性大肠组(AOR=3.6,95%置信区间:1.3,9.8)和坏疽性小肠组(AOR=4.2,95%置信区间:1.3,13.7)与不良手术结局显著相关。

结论

不良手术结局发生率较高。年龄、疾病晚期出现和肠坏死性梗阻与不良结局显著相关。因此,应关注较晚就诊和年龄较大的患者的早期发现和随访。

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