Situational analysis on the recovery of patients who have undergone major abdominal surgery

Udomkhwamsuk, Warawan; Vuttanon, Nuttamon; Limpakan, Sirikan

doi:10.1002/nop2.612

Cited by 7 publications

(4 citation statements)

References 14 publications

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“…Effective postoperative care should therefore aim to shorten hospital stays and decrease complications. 11,12 W investigated factors associated with prolonged length of stay after strictureplasty for Crohn's disease. We found that higher ASA class, longer operative time, and incidence of SSI were associated with increased odds of prolonged length of stay, while male sex and preoperative steroid use reduced the odds.…”

Section: Discussionmentioning

confidence: 99%

Predictors of 30-Day Readmission & Reoperations Post Strictureplasty in Crohn’s Disease: A NSQIP Retrospective Review and Analysis

Patel

Satchell

Guru

et al. 2022

Preprint

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INTRODUCTION Strictureplasty, introduced in 1978, has been suggested as an alternative to small bowel resection for cases of intestinal obstruction involving multiple segments, such as in Crohn's disease. Despite research supporting the operation, little is known about outcomes after strictureplasty. Specifically, 30-day readmission and reoperation rates, which are widely recognized as surrogates for quality of surgical care have not been studied for this procedure. We sought to study the rate of, as well as factors associated with 30-day outcomes, including readmission and reoperation. METHODS We used the National Surgical Quality Improvement Program (NSQIP) participant user files (PUF) for the years 2012-2020. Primary Current Procedural Terminology (CPT) code "44615" was used to identify patients undergoing strictureplasty as their principal procedure. The outcomes of interest included related thirty-day readmissions and reoperations, non-routine discharge, and prolonged length of stay (LOS). Multivariable analyses were performed to identify factors associated with each outcome. RESULTS A total of 535 patients were identified with mean age 44.14 years (SD= 15.74). 52.5% were female. Thirty-day related readmission and reoperation rates were 9% (n=48) and 6% (n=32) respectively. Average LOS was 8.16 days (SD= 6.9). Non-routine discharge rate was4.2% (n=21). On multivariable logistic regression, factors associated with 30-day readmissions included longer operative time (OR 1.00, 95% CI 1.00-1.01, p=0.0008) and any surgical site infection (SSI) (OR 6.4, 95% CI 2.89-14.2, p<0.001). Increased LOS (OR 1.7, 95%CI 1.03-1.11, p=0.0009) and SSI (OR 28.1, 95%CI 10.44-75.47, p<0.001) were associated with 30-day related reoperation. Predictors of non-routine discharge included older age (65+ vs 18-40: OR 30.72, 95%CI 3.14-300.74, p=0.003) and longer LOS (OR 1.09, 95%CI 1.03-1.14, 0.0009). Factors associated with increased odds of prolonged LOS included higher ASA class (OR 3.29, 95%CI 2.10-5.14, p<0.001), longer operative time (1.00, 95%CI 1.00-1.01, p=0.0008) and SSI (OR 3.05, 95%CI 1.57-5.90, p=0.0009). Factors associated with lower odds of prolonged LOS included male sex (OR 0.56, 96%CI 0.36-0.88, p=0.011) and preoperative steroid use (OR 0.62, 95%CI 0.38-0.99, p=0.04). CONCLUSION Our analyses indicate that among patients undergoing strictureplasty, longer operative time, wound complications, and longer length of stay are associated with increased odds of readmission and reoperation within 30 days. These findings may be important for hospitals, providers, payors, and other stakeholders in further refining standards of quality of care for patients undergoing strictureplasty.

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Section: Discussionmentioning

confidence: 99%

Predictors of 30-Day Readmission & Reoperations Post Strictureplasty in Crohn’s Disease: A NSQIP Retrospective Review and Analysis

Patel

Satchell

Guru

et al. 2022

Preprint

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“…Abdominal surgery refers to the operation of abdominal organs to repair accidental injuries, peritonitis, abdominal abscess and digestive tract diseases. [1] The incidence of complications after abdominal surgery is high, including pulmonary infection, abdominal distension, intestinal adhesion, venous thrombosis and so on. Among them, the incidence of intestinal adhesion is as high as 95%, and the case fatality rate is 8%-13%, which has become a major clinical challenge for abdominal surgery.…”

Section: Introductionmentioning

confidence: 99%

Effect of nursing intervention to guide early postoperative activities on rapid rehabilitation of patients undergoing abdominal surgery

Rao

Liu

et al. 2021

Medicine

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Background: Postoperative complications after abdominal surgery are high, and there is no reliable intervention program to prevent them. Some studies have pointed out that early postoperative activities have advantages in preventing the occurrence of complications, but lack of evidence-based basis. The purpose of this study is to systematically evaluate the effect of nursing intervention is guiding early postoperative activities on the rapid recovery of patients undergoing abdominal surgery. Methods: China National Knowledge Infrastructure, Wanfang, China Science and Technology Journal Database and Chinese Biomedical Database, PubMed, Embase, Web of Science and the Cochrane Library will be searched by computer, and a randomized controlled study is conducted on early participation in exercise programs after abdominal surgery from the establishment of the database to January 2021. The language is limited to English and Chinese. The quality of the included study is independently extracted and the literature quality is evaluated by 2 researchers, and the included literature is analyzed by Meta using RevMan5.3 software. Results: This study will evaluate the effect of nursing intervention is guiding early postoperative activities on the rapid rehabilitation of patients undergoing abdominal surgery through the indexes of postoperative quality of life score, the incidence of complications, mortality, length of stay and so on. Conclusion: This study will provide reliable evidence-based basis for establishing a reasonable and effective postoperative activity guidance program for patients undergoing abdominal surgery. Ethics and dissemination: Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval will not be required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences. OSF Registration number: DOI 10.17605/OSF.IO/59MD4

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“…It refers to surgery on abdominal organs to restore and treat some diseases, such as digestive tract diseases, abdominal abscess, peritonitis, and accidental injuries. [1] There is a high incidence rate of postsurgical complications associated with abdominal surgeries, these include abdominal distension, lung infections, venous thrombosis, and intestinal adhesions. Some believe that in the postabdominal surgical period, there is a high likelihood for the vitality to be severely damaged, and that inpatients should remain in bed in the immediate period following surgery.…”

Section: Introductionmentioning

confidence: 99%

“…Abdominal surgery is one of the most commonly performed surgeries in clinical practices. It refers to surgery on abdominal organs to restore and treat some diseases, such as digestive tract diseases, abdominal abscess, peritonitis, and accidental injuries [1] . There is a high incidence rate of postsurgical complications associated with abdominal surgeries, these include abdominal distension, lung infections, venous thrombosis, and intestinal adhesions.…”

Section: Introductionmentioning

confidence: 99%

Impact of early postoperative activities on postoperative recovery in patients undergoing abdominal surgery

Fang¹,

Ding²,

Zeng³

et al. 2021

Medicine

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Introduction:A refined nursing process is utilized to formulate a detailed early postsurgical activity plan. The postsurgical activity aims to conduct focused and planned interventions to address the early postoperative activities of patients, enhance the awareness and compliance of the patients through the early postsurgical activities. Currently, in traditional clinical practice, there is no clear evidence showing the effect of initial postsurgical actions related to the rehabilitation of inpatients undertaking abdominal operations. The present study will systematically evaluate how initial postsurgical actions impact the rehabilitation of patients undertaking abdominal operation through the analysis of relevant domestic and foreign literature.Objective:Analyze the how initial postsurgical actions impact the rehabilitation of abdominal surgery inpatients.Methods and analysis:The present systematic study will retrieve randomized controlled trials and case-control studies from online databases. The retrieved studies will describe the initial postsurgical activities in inpatients undergoing abdominal surgery. Accordingly, the following databases are searched for the aforementioned types of studies: Cochrane library, China National of Knowledge Infrastructure, Web of Science, PubMed database, WanFang database, and Embase database. Studies from inception to August 19, 2021 will be searched. The quality evaluation and data extraction for the studies that will satisfy the inclusion criteria will be conducted by 2 independent researchers. A meta-analysis on the postoperative indicators will be performed using RevMan 5.3.5 software.

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Situational analysis on the recovery of patients who have undergone major abdominal surgery

Cited by 7 publications

References 14 publications

Predictors of 30-Day Readmission & Reoperations Post Strictureplasty in Crohn’s Disease: A NSQIP Retrospective Review and Analysis

Predictors of 30-Day Readmission & Reoperations Post Strictureplasty in Crohn’s Disease: A NSQIP Retrospective Review and Analysis

Effect of nursing intervention to guide early postoperative activities on rapid rehabilitation of patients undergoing abdominal surgery

Impact of early postoperative activities on postoperative recovery in patients undergoing abdominal surgery

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