McAleese P, Odling-Smee W
Department of Surgery, Royal Victoria Hospital, Belfast, Northern Ireland.
Ann Surg. 1994 Dec;220(6):740-4. doi: 10.1097/00000658-199412000-00006.
The authors determined the effect of complications on length of stay (LOS) in surgical patients.
From 1987 to 1990, in the Professional General Surgical Unit of Royal Victoria Hospital, a retrospective survey was conducted on 5128 consecutively admitted patients with 396 different diagnosis; 228 different operations were examined.
Patient LOS during a 3-year period in a general surgical ward was analyzed from hospital activity analysis, case notes, ward audit notes, and sepsis audit notes. Readmission rates for complications in patients with a short LOS were examined. Comparison were made between LOS and age, type of surgery, and complication type.
Pressure on beds resulting from an increased demand on surgical care decreases patient's hospital LOS; increasing age increases LOS. In general, complications double the average LOS. The authors calculated that a surgical complication can be given a numerical ratio that directly reflects the severity of the complication and increases the patient's LOS. The ration of the infective complication corresponds with the clinical severity of the complication. However, a short LOS may lead to readmission of patients for further treatment. For patients readmitted with complications, 41% had been discharged earlier than the average LOS for their diagnosis.
Length of stay is increased by complications and can be used to implement discharge planning in general surgical patients. Furthermore, a complication of their treatment can be given a numerical ratio that corresponds to the clinical severity of the complication and the increased LOS in hospital.
作者确定了并发症对外科手术患者住院时间（LOS）的影响。
1987年至1990年期间，在皇家维多利亚医院的普通外科专业科室，对5128例连续入院、诊断不同（共396种）的患者进行了回顾性调查；对228种不同手术进行了检查。
通过医院活动分析、病历、病房审核记录和脓毒症审核记录，分析普通外科病房患者在3年期间的住院时间。研究了住院时间短的患者并发症的再入院率。对住院时间与年龄、手术类型和并发症类型进行了比较。
手术护理需求增加导致的床位压力会缩短患者的住院时间；年龄增加会延长住院时间。一般来说，并发症会使平均住院时间加倍。作者计算出，可以给手术并发症一个数值比例，该比例直接反映并发症的严重程度并延长患者的住院时间。感染性并发症的比例与并发症的临床严重程度相对应。然而，住院时间短可能导致患者再次入院接受进一步治疗。对于因并发症再次入院的患者，41%的患者出院时间早于其诊断对应的平均住院时间。
并发症会延长住院时间，可用于制定普通外科患者的出院计划。此外，其治疗并发症可以用一个数值比例来表示，该比例与并发症的临床严重程度和住院时间延长相对应。
