首页    期刊浏览 2024年11月29日 星期五
登录注册

文章基本信息

  • 标题:Association between emergency department length of stay and adverse perioperative outcomes in emergency surgery: a cohort study in two Colombian University hospitals
  • 本地全文:下载
  • 作者:Félix R. Montes ; Skarlet Marcell Vásquez ; Claudia Marcela Camargo-Rojas
  • 期刊名称:BMC Emergency Medicine
  • 印刷版ISSN:1471-227X
  • 电子版ISSN:1471-227X
  • 出版年度:2019
  • 卷号:19
  • 期号:1
  • 页码:1-10
  • DOI:10.1186/s12873-019-0241-6
  • 出版社:BioMed Central
  • 摘要:In low- and middle-income countries emergency surgery represents a higher proportion of the total number of surgeries and is associated with greater morbidity/mortality. Study aims were to determine if emergency department length of stay (ED-LOS) was associated with adverse perioperative outcomes and if such association varied across patient’s risk categories. A retrospective cohort study was conducted of adult patients who underwent orthopedic or abdominal emergency surgery at two Colombian University hospitals. The population comprised a mix of a representative sample of eligible cases, with unselected patients (2/3), enriched with a high-risk subset (1/3). ED-LOS was defined as the interval between emergency department arrival and surgery start time. Our primary outcome was an adverse perioperative outcome during hospitalization, which was a composite of in-hospital mortality or severe complications such as major cardiovascular adverse events, infection, renal failure and bleeding. Among 1487 patients analyzed, there were 519 adverse perioperative outcomes including 150 deaths. In the unselected sample (n = 998) 17.9% of patients presented an adverse perioperative outcome with a mortality of 4.9%. The median ED-LOS was 24.6 (IQR 12.5–53.2) hours. ED-LOS was associated with age, comorbidities and known risk factors for 30-day mortality. Patients developing an adverse perioperative outcome started surgery 27.1 h later than their counterparts. Prolonged ED-LOS increased the risk of an adverse perioperative outcome in patients without risk factors (covariate-adjusted OR = 2.52), while having 1–2 or 3+ risk factors was negatively associated (OR = 0.87 and 0.72, respectively, p < 0.001 for the interaction). Prolonged ED-LOS is associated with increased adverse perioperative outcome for patients without risk factors for mortality, but seems protective and medically justified for more complex cases.
  • 关键词:Emergency surgery ; Emergency department ; Length of stay ; Outcome
国家哲学社会科学文献中心版权所有