PDF(Pubmed)
Abstract：
BACKGROUND: Laparotomy surgery, which involves making an incision in the abdominal cavity to treat serious abdominal disease and save the patient\'s life, causes significant deaths in both developed and developing countries, including Ethiopia. The number studies examining in-hospital mortality rates among individuals that undergone laparotomy surgery and associated risk factors is limited.
OBJECTIVE: To assess the magnitude of in-hospital mortality and its associated factors among patients undergone laparotomy at tertiary hospitals, West Oromia, Ethiopia, 2022.
METHODS: An institutional based retrospective cross-sectional study was conducted from January 1, 2017, to December 31, 2021. Data were collected using systematic random sampling and based on structured and pretested abstraction sheets from 548 medical records and patient register log. Data were checked for completeness and consistency, coded, imported using Epi-data version 4.6, cleaned and analyzed using SPSS version 25 software. Variables with p < 0.2 in the Bi-variable logistic regression analysis were included in the multivariate logistic regression analysis. The fit of the model was checked by the Hosmer‒Lemeshow test. Using the odds ratio adjusted to 95% CI and a p value of 0.05, statistical significance was declared.
RESULTS: A total of 512 patient charts were reviewed, and the response rate was 93.43%. The overall magnitude of in-hospital mortality was 7.42% [95% CI: 5.4-9.8]. American society of Anesthesiology physiological status greater than III [AOR = 7.64 (95% CI: 3.12-18.66)], systolic blood pressure less than 90 mmHg [AOR = 6.11 (95% CI: 1.98-18.80)], preoperative sepsis [AOR = 3.54 (95% CI: 1.53-8.19)], ICU admission [AOR = 4.75 (95% CI: 1.50-14.96)], and total hospital stay greater than 14 days [(AOR = 6.76 (95% CI: 2.50-18.26)] were significantly associated with mortality after laparotomy surgery.
CONCLUSIONS: In this study, overall in- hospital mortality was high. Early identification patient\'s American Society of Anesthesiologists physiological status and provision of early appropriate intervention, and pays special attention to patients admitted with low systolic blood pressure, preoperative sepsis, intensive care unit admission and prolonged hospital stay to improve patient outcomes after laparotomy surgery.
OBJECTIVE: To assess the magnitude of in-hospital mortality and its associated factors among patients undergone laparotomy at tertiary hospitals, West Oromia, Ethiopia, 2022.
METHODS: An institutional based retrospective cross-sectional study was conducted from January 1, 2017, to December 31, 2021. Data were collected using systematic random sampling and based on structured and pretested abstraction sheets from 548 medical records and patient register log. Data were checked for completeness and consistency, coded, imported using Epi-data version 4.6, cleaned and analyzed using SPSS version 25 software. Variables with p < 0.2 in the Bi-variable logistic regression analysis were included in the multivariate logistic regression analysis. The fit of the model was checked by the Hosmer‒Lemeshow test. Using the odds ratio adjusted to 95% CI and a p value of 0.05, statistical significance was declared.
RESULTS: A total of 512 patient charts were reviewed, and the response rate was 93.43%. The overall magnitude of in-hospital mortality was 7.42% [95% CI: 5.4-9.8]. American society of Anesthesiology physiological status greater than III [AOR = 7.64 (95% CI: 3.12-18.66)], systolic blood pressure less than 90 mmHg [AOR = 6.11 (95% CI: 1.98-18.80)], preoperative sepsis [AOR = 3.54 (95% CI: 1.53-8.19)], ICU admission [AOR = 4.75 (95% CI: 1.50-14.96)], and total hospital stay greater than 14 days [(AOR = 6.76 (95% CI: 2.50-18.26)] were significantly associated with mortality after laparotomy surgery.
CONCLUSIONS: In this study, overall in- hospital mortality was high. Early identification patient\'s American Society of Anesthesiologists physiological status and provision of early appropriate intervention, and pays special attention to patients admitted with low systolic blood pressure, preoperative sepsis, intensive care unit admission and prolonged hospital stay to improve patient outcomes after laparotomy surgery.
摘要：
背景：剖腹手术，这包括在腹腔做一个切口来治疗严重的腹部疾病，挽救病人的生命，在发达国家和发展中国家造成大量死亡，包括埃塞俄比亚。研究剖腹手术患者住院死亡率和相关危险因素的研究数量有限。
目的：评估三级医院剖腹手术患者的院内死亡率及其相关因素，西奥罗米亚,埃塞俄比亚,2022年。
方法：从2017年1月1日至2021年12月31日进行了基于机构的回顾性横断面研究。使用系统随机抽样并基于来自548个医疗记录和患者登记日志的结构化和预先测试的抽象表收集数据。检查了数据的完整性和一致性，编码,使用Epi-data4.6版导入，使用SPSS25版软件进行清理和分析。双变量逻辑回归分析中p<0.2的变量包括在多变量逻辑回归分析中。通过Hosmer-Lemeshow测试检查了模型的拟合度。使用调整为95%CI和p值为0.05的比值比，宣布有统计学意义。
结果：共审查了512例患者的图表，有效率为93.43%。住院死亡率的总体幅度为7.42%[95%CI:5.4-9.8]。美国麻醉学协会的生理状态大于III[AOR=7.64（95％CI：3.12-18.66）]，收缩压小于90mmHg[AOR=6.11（95％CI：1.98-18.80）]，术前脓毒症[AOR=3.54（95%CI：1.53-8.19）]，ICU入院[AOR=4.75（95%CI：1.50-14.96）]，总住院时间超过14天[(AOR=6.76(95%CI:2.50-18.26)]与剖腹手术后死亡率显著相关.
结论：在这项研究中，总体院内死亡率较高.早期识别患者的美国麻醉医师协会的生理状态并提供早期适当的干预措施,并特别关注收缩压低的患者，术前脓毒症,重症监护病房的入院和延长住院时间，以改善开腹手术后患者的预后。
目的：评估三级医院剖腹手术患者的院内死亡率及其相关因素，西奥罗米亚,埃塞俄比亚,2022年。
方法：从2017年1月1日至2021年12月31日进行了基于机构的回顾性横断面研究。使用系统随机抽样并基于来自548个医疗记录和患者登记日志的结构化和预先测试的抽象表收集数据。检查了数据的完整性和一致性，编码,使用Epi-data4.6版导入，使用SPSS25版软件进行清理和分析。双变量逻辑回归分析中p<0.2的变量包括在多变量逻辑回归分析中。通过Hosmer-Lemeshow测试检查了模型的拟合度。使用调整为95%CI和p值为0.05的比值比，宣布有统计学意义。
结果：共审查了512例患者的图表，有效率为93.43%。住院死亡率的总体幅度为7.42%[95%CI:5.4-9.8]。美国麻醉学协会的生理状态大于III[AOR=7.64（95％CI：3.12-18.66）]，收缩压小于90mmHg[AOR=6.11（95％CI：1.98-18.80）]，术前脓毒症[AOR=3.54（95%CI：1.53-8.19）]，ICU入院[AOR=4.75（95%CI：1.50-14.96）]，总住院时间超过14天[(AOR=6.76(95%CI:2.50-18.26)]与剖腹手术后死亡率显著相关.
结论：在这项研究中，总体院内死亡率较高.早期识别患者的美国麻醉医师协会的生理状态并提供早期适当的干预措施,并特别关注收缩压低的患者，术前脓毒症,重症监护病房的入院和延长住院时间，以改善开腹手术后患者的预后。
