Análisis de la calidad en la atención del paciente de cirugía general de urgencia

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instname:Universidad del Rosario

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Baquero Zamarra, David Ricardo; Especialista en Cirugía General
Facultad de Medicina; Universidad del Rosario
Cirugía General de Urgencia, indicadores de calidad, mortalidad, morbilidad, registro electrónico de datos.; General Surgery Emergency, quality indicators, mortality, morbidity, electronic data register.; Atención al paciente; Calidad de la atención de salud - Medición; Cirugía general; Urgencias médicas
thesis / dissertation description
Objective: to propose an instrument for the quality follow-up in patients with urgent abdominal surgical pathology. Methods: clinical records from August 2013 were retrospectively reviewed looking for adult patients who needed General Surgery Emergency Care (GSEC). Different demographic, severity, and outcome variables were analysed, as well as different risk factors, until the 30th postoperatory day. Quality indicators from the National Surgical Quality Improvement Program (NSQIP), National Trauma Data Bank, plus others, were included. Results: 231 patients were operated from 261 different GSEC procedures. Average age was 49 years old. The most common procedures practiced were laparoscopic cholecystectomy (37.2%), open appendectomy (35.6%), exploratory laparotomy (12.6%), intraabdominal collection drainage (9.1%), and lysis of intraabdominal adhesions causing bowel obstruction (6.9%). There was a 3.46% (n=8) mortality, and 8.04% of severe morbidity. Global in-hospital stay length was 6.54 days +/- 5.18, and Intensive Care Unit stay was 5.7 days +/- 4.42. Availability of the Operating Rooms for perforated appendicitis with generalized peritonitis was 5 hours, for localized appendicitis was 8 hours, acute cholecystitis 37 hours, colangitis 7.48 hours, and diverticulitis 2.42 hours. Conclusions: the creation of a quality measuring instrument for GSEC patients is necessary for institution’s autoevaluation, and to define improvement plans and distribution of the finantial resources.