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2023年资源有限地区非创伤性急诊剖腹术后计划外再次剖腹手术的患病率及相关因素:一项回顾性病历审查

Prevalence and Associated Factors of Unplanned Re-Laparatomy after Non-Trauma Emergency Laparatomy in Resource-Limited Settings, 2023: A Retrospective Chart Review.

作者信息

Dessalegn Megbar, Deresse Tilahun, Eskandar George, Birhanu Molla Yigzaw

机构信息

Department of Surgery, School of Medicine, Debre Markos University.

Department of Surgery, School of Medicine, Debre Birhan University.

出版信息

Ethiop J Health Sci. 2024 May;34(3):195-202. doi: 10.4314/ejhs.v34i3.4.

Abstract

BACKGROUND

Emergency laparatomy may need subsequent re-laparatomy which has high rate of mortality. However, reports on rates and associated factors of un-planned re-laparatomy are few. This study aimed to determine the prevalence and associated factors of re-laparotomy after non-trauma emergency laparatomy at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia, 2023.

METHODS

This was a retrospective chart review conducted at Debre Markos Comprehensive Specialized Hospital in Ethiopia among patients who had undergone emergency laparatomy between January 1, 2019 and December 31, 2022. A sample of 384 individuals were selected using simple random sampling technique. Data were extracted from March 01, 2023, to May 1, 2023, cleaned, entered into Epi-Data version 3.1, and analyzed with STATA version 14.1. Predictor variables with P value < 0.05 in multivariable logistic regression were reported.

RESULTS

From 384 patients who had emergency laparatomy, 33(8.6%) needed re-laparatomy in the early post-operative period. All re-laparotomies were unplanned and done during the primary Hospital admission period Patients who were hypotensive preoperatively[AOR: 3.3 (95% CI: (1.88, 9.40))] and with longer operation time (greater than 1 hour) [AOR: 4.5 (95% CI: (1.88, 10.64)] had increased risk for unplanned re-laparatomy.

CONCLUSION

The re-laparatomy rate in this study was high with higher risk among patients with preoperative hypotension and longer procedure time. The findings emphasize a need for advocacy on preoperative patient resuscitation and monitoring.

摘要

背景

急诊剖腹手术可能需要后续再次剖腹手术,其死亡率很高。然而,关于非计划再次剖腹手术的发生率及相关因素的报道较少。本研究旨在确定2023年埃塞俄比亚西北部德布雷马科斯综合专科医院非创伤性急诊剖腹手术后再次剖腹手术的患病率及相关因素。

方法

这是一项在埃塞俄比亚德布雷马科斯综合专科医院对2019年1月1日至2022年12月31日期间接受急诊剖腹手术的患者进行的回顾性病历审查。采用简单随机抽样技术选取了384名个体作为样本。数据于2023年3月1日至5月1日提取、清理,录入Epi-Data 3.1版本,并使用STATA 14.1版本进行分析。报告多变量逻辑回归中P值<0.05的预测变量。

结果

在384例接受急诊剖腹手术的患者中,33例(8.6%)在术后早期需要再次剖腹手术。所有再次剖腹手术均为非计划的,且在首次住院期间进行。术前低血压患者[调整后比值比:3.3(95%置信区间:(1.88, 9.40))]和手术时间较长(大于1小时)的患者[调整后比值比:4.5(95%置信区间:(1.88, 10.64))]非计划再次剖腹手术的风险增加。

结论

本研究中的再次剖腹手术率较高,术前低血压和手术时间较长的患者风险更高。研究结果强调了对术前患者复苏和监测进行宣传的必要性。

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