García-Cabrera Ana María, de la Portilla de Juan Fernando, Navarro-Morales Laura, Ribera García Sebastián, Durán Ventura María Del Carmen, Fernández Luque Inés, Padillo-Ruiz Francisco Javier
Ana María García-Cabrera, MD, PhD, Virgen del Rocío University Hospital, Seville, Spain.
Fernando de la Portilla de Juan, MD, PhD, Virgen del Rocío University Hospital, Seville, Spain.
J Wound Ostomy Continence Nurs. 2023;50(6):484-488. doi: 10.1097/WON.0000000000001020.
This aim of this study was to compare the impact on hospital stay and short-term overall complications prior to and following the introduction of an outpatient preoperative ostomy education program to an existing inpatient ostomy education program.
A comparison cohort study.
One hundred thirty-eight consecutive patients undergoing ostomy surgery were included. One group (n = 65, 47%) was given an experimental preoperative ostomy education intervention, along with standard care including a postoperative educational intervention during the initial hospital course. A second group (n = 73, 53%) received the same standardized education in the postoperative period. Data were collected from a single tertiary center located in Seville, Spain, during a 12-month period between July 2014 and June 2015.
Data were collected in 2 phases. Data from participants undergoing postoperative (standard) education were collected retrospectively. Data for the group receiving preoperative education were collective prospectively. Outcome variables were postoperative length of stay, surgical complications (severity was assessed by the Clavien-Dindo grading system), subsequent interventions, and readmission rates.
Analysis indicated no differences between the average length of postoperative hospital stay (12.32 days in the preoperative education group vs 12.76 days in the postoperative education group, P = .401). In contrast, overall complications, mortality, and readmission rates were significantly higher in the preoperative education program group (P = .027, P = .047, and P = .046, respectively).
Delivering a standardized educational intervention during the preoperative period versus postoperative education delivery during the ostomy surgery hospital course did not reduce length of stay. Analysis indicated that overall complications, mortality, and readmission rates were significantly higher in the preoperative education program group but we hypothesize that intervening factors may have influenced these outcomes.
本研究旨在比较在现有住院造口教育项目基础上引入门诊术前造口教育项目前后，对住院时间和短期总体并发症的影响。
一项比较队列研究。
纳入138例连续接受造口手术的患者。一组（n = 65，47%）接受了实验性术前造口教育干预，以及包括在初始住院期间进行术后教育干预在内的标准护理。另一组（n = 73，53%）在术后接受相同的标准化教育。数据收集于西班牙塞维利亚的一家单一三级中心，时间为2014年7月至2015年6月的12个月期间。
分两个阶段收集数据。对接受术后（标准）教育的参与者的数据进行回顾性收集。对接受术前教育组的数据进行前瞻性收集。结果变量包括术后住院时间、手术并发症（严重程度通过Clavien-Dindo分级系统评估）、后续干预措施和再入院率。
分析表明，术后平均住院时间无差异（术前教育组为12.32天，术后教育组为12.76天，P = 0.401）。相比之下，术前教育项目组的总体并发症、死亡率和再入院率显著更高（分别为P = 0.027、P = 0.047和P = 0.046）。
在术前而非造口手术住院期间进行术后教育时提供标准化教育干预并不能缩短住院时间。分析表明，术前教育项目组的总体并发症、死亡率和再入院率显著更高，但我们推测干预因素可能影响了这些结果。
