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Factores de riesgo de presentar una complicación postoperatoria en pacientes operados de urgencia por patología herniaria / Risk factors for complications and mortality after emergency surgery for complicated hernias
Venturelli M., Francisco.
  • Venturelli M., Francisco; Universidad Austral de Chile. Campo Clínico Osorno. CL
Rev. chil. cir ; 63(2): 178-185, abr. 2011. ilus
Article in Spanish | LILACS | ID: lil-582969
ABSTRACT

Background:

Thirteen percent of hernias require emergency surgery and of these, approximately 14 percent require an intestinal excision.

Aim:

To identify risk factors for postoperative complications after emergency surgical treatment of complicated hernias. Material and

Methods:

Using surgical room registries, all patients subjected to emergency surgery for complicated hernias between 2004 and 2008 were identified and their medical records were reviewed. Follow up was performed using data from hospital and outpatient medical records.

Results:

One hundred fifty two patients were identified but four were discarded due to lack of complete records. Therefore, 148 patients aged 24 to 95 years (104 females) were analyzed. Forty patients had postoperative complications (27 percent) and six died (4 percent). Obesity, hypertension, diabetes mellitus and an American Society of Anesthesiologists (ASA) classification, III or IV, were identified as risk factors for complications. Logistic regression only accepted hypertension as a risk factor with an odds ratio (OR) of 2.35 (95 percent confidence intervals (CI) 1.04-5.3). The predictors for mortality were obesity, hypertension, an ASA classification of III or IV and having a strangulated hernia. Logistic regression only accepted having a strangulated hernia as an independent risk factor with an OR of 16.4 (95 percent CI 1.6-167.7).

Conclusions:

Hypertension and having a strangulated hernia are risk factors for complications and mortality after emergency surgery for complicated hernias.
RESUMEN

Introducción:

Obteniendo los factores de riesgo de morbimortalidad postoperatoria, al tratar una hernia complicada de urgencia, podríamos definir mejor su tratamiento. Objetivo principal Identificar los factores de riesgo de morbilidad postoperatoria en pacientes operados de urgencia por una hernia complicada en el Hospital Base de Osorno (HBO). Material y

Método:

Cohorte retrospectiva. Se incluyeron pacientes mayores de 14 años operados por patología hemiaria complicada en el servicio de urgencia del HBO entre los años 2004 y 2008. Se excluyeron aquellos que no contaron con datos en las variables de interés. Se realizó un análisis bivariado y una regresión logística. Medida de riesgo odds ratio (OR). Intervalo de confianza 95 por ciento. Stata 10.0.

Resultados:

La cohorte incluyó 148 pacientes. Mediana de edad 66 años (24-95). La morbilidad y mortalidad postoperatoria fue un 27,02 por ciento (40 pacientes) y 4,05 por ciento (6 pacientes) respectivamente. Las variables obesidad, hipertensión arterial (HTA), diabetes mellitus (DM) y el tener un ASA III-IV resultaron ser significativas (p < 0,05) para morbilidad postoperatoria en el análisis bivariado. En la regresión logística, sólo el ser hipertenso resultó ser un factor de riesgo (OR 2,35, IC 95 por ciento 1,04-5,30). Los factores de riesgo para mortalidad que resultaron significativos en el análisis bivariado fueron ser obeso, hipertenso, presentar un ASA de III-IV y presentar hernia estrangulada (p < 0,05). En el análisis multivariado sólo el presentar una hernia estrangulada fue un factor de riesgo (OR 16,4, IC 95 por ciento 1,59-167,76).

Conclusión:

Ser hipertenso y la presencia de necrosis en el saco hemiario son factores de morbilidad y mortalidad postoperatoria respectivamente en el paciente que se opera por una hernia complicada de urgencia.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Surgical Procedures, Operative / Hernia, Abdominal / Emergencies Type of study: Etiology study / Health technology assessment / Observational study / Prognostic study / Risk factors Limits: Adult / Aged / Aged80 / Female / Humans / Male Language: Spanish Journal: Rev. chil. cir Journal subject: General Surgery Year: 2011 Type: Article Affiliation country: Chile Institution/Affiliation country: Universidad Austral de Chile/CL

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Full text: Available Index: LILACS (Americas) Main subject: Surgical Procedures, Operative / Hernia, Abdominal / Emergencies Type of study: Etiology study / Health technology assessment / Observational study / Prognostic study / Risk factors Limits: Adult / Aged / Aged80 / Female / Humans / Male Language: Spanish Journal: Rev. chil. cir Journal subject: General Surgery Year: 2011 Type: Article Affiliation country: Chile Institution/Affiliation country: Universidad Austral de Chile/CL