Publicado
Prevalence of surgical complications in gynecological surgery at the Hospital Universitario San José in Popayán, Colombia. 2015
Prevalencia de complicaciones quirúrgicas en cirugía ginecológica, Hospital Universitario San José de Popayán, Colombia. 2015
DOI:
https://doi.org/10.15446/revfacmed.v66n4.63743Palabras clave:
Prevalence, Surgery, Gynecology (en)Prevalencia, Cirugía, Ginecología (es)
Descargas
Introduction: Every surgery has risk of complications; prognosis depends on prompt diagnosis and timely management.
Objective: To determine the prevalence of surgical complications in gynecological surgery in a tertiary care hospital and to explore associated factors.
Materials and methods: Prevalence study with secondary analysis of medical records of patients who underwent scheduled gynecological surgery. The outcome variable was complications reported during a period of less than 30 days. The universe was established, and clinical, biological and sociodemographic variables were collected. To determine prevalence, the total number of complications was taken as the numerator and the total number of records was used as the denominator. To explore associated factors, odds ratio (OR) was used as a measure of association with a 95% CI.
Results: 591 records were reviewed, finding a surgical management of ectopic pregnancy prevalence of 3.8% (OR=3.73, CI95%: 2.41-92.52). Obesity (OR 12.47, CI95%: 4.48-33.19) and gynecological surgery for malignancy (OR 3.73, CI95%: 1.14- 10.48) were associated with complications.
Conclusion: The prevalence found in our institution was similar to what most studies have reported.
Introducción. Toda cirugía implica riesgo de complicaciones; el pronóstico depende de su pronto diagnóstico y manejo oportuno.
Objetivo. Determinar la prevalencia de complicaciones quirúrgicas en cirugía ginecológica en un hospital de alta complejidad y explorar factores asociados.
Materiales y métodos. Estudio de prevalencia con análisis secundario en el que se incluyeron historias de pacientes sometidas a cirugía ginecológica programada. La variable resultado fue la complicación reportada durante un periodo <30 días. Se tomó el universo y se recolectaron variables clínicas, biológicas y sociodemográficas. Para determinar la prevalencia se tomó como numerador el total de complicaciones y como denominador el total de historias; para explorar los factores asociados se utilizó el Odds Ratio como medida de asociación con un índice de confianza al 95%.
Resultados. Se revisaron 591 historias clínicas y la prevalencia encontrada fue del 3.8% (IC95%: 2.3-5.4). La historia de manejo quirúrgico del ectópico (OR: 16.89; IC95%: 2.41-92.52), la obesidad (OR: 12.47; IC95%: 4.48-33.19) y la cirugía ginecología por malignidad (OR: 3.73; IC95%: 1.14-10.48) se asociaron con complicaciones.
Conclusión: La prevalencia encontrada fue similar a la de la mayor parte de los estudios consultados.
Referencias
Coelho SM, Perez Ede L, Lins CD, Gomes MT, Bella ZI, Andres Mde P, et al. Epidemiological profile and postoperative complications of women undergoing gynecological surgery in a reference center in the northern Brazilian legal amazon. Rev Col Bras Cir. 2015;42(6):372-5. http://doi.org/cnhj.
Hammer A, Rositch AF, Kahlert J, Gravitt PE, Blaakaer J, Søgaard M. Global epidemiology of hysterectomy: possible impact on gynecological cancer rates. Am J Obstet Gynecol. 2015;213(1):23-9. http://doi.org/f3htqf.
Barbosa-Merighi MA, de Oliveira DM, Pinto-de Jesus MC, Akiko-Komura-Hoga L, de Oliveira-Pedroso AG. Experiências e expectativas de mulheres submetidas à histerectomia. Texto Contexto - Enferm. 2012;21(3):608-15. http://doi.org/cnhk.
Barbosa G, Garnica L. Prevalencia de complicaciones y factores predisponentes en cirugía ginecológica por patología benigna en el hospital universitario San Ignacio: Bogotá, Colombia. Rev Chil Obstet Ginecol. 2015;80(6):456-61. http://doi.org/cnhm.
Sokol DK, Wilson J. What is a surgical complication? World J Surg. 2008;32(6):942-4. http://doi.org/dkj6xs.
Taylor-Adams S, Vincent C. System Analysis of Clinical Incidents: The London Protocol. London: Clinical Safety Research Unit, Imperial College; 2004.
World Health Organization. Marco Conceptual de la Clasificación Internacional para la Seguridad del Paciente. Informe Técnico Definitivo. WHO; 2009.
Sisko A, Truffer C, Smith S, Keehan S, Cylus J, Poisal JA, et al. Health spending projections through 2018: recession effects add uncertainty to the outlook. Health Aff (Millwod). 2009;28(2):w346-57. http://doi.org/cfrfvr.
Putz A, Bohlin T, Rakovan M, Putz AM, De Wilde RL. European operative registry to avoid complications in operative gynecology. Best Pract Res Clin Obstet Gynaecol. 2016;35:113-23. http://doi.org/f8zp83.
Vonlanthen R, Slankamenac K, Breitenstein S, Puhan MA, Muller MK, Hahnloser D, et al. The impact of complications on costs of major surgical procedures: a cost analysis of 1200 patients. Ann Surg. 2011;254(6):907-13. http://doi.org/dv5x52.
Erekson EA, Yip SO, Ciarleglio MM, Fried TR. Postoperative complications after gynecologic surgery. Obstet Gynecol. 2011;118(4):785-93. http://doi.org/dg7635.
Brummer TH, Jalkanen J, Fraser J, Heikkinen AM, Kauko M, Mäkinen J, et al. FINHYST, a prospective study of 5279 hysterectomies: complications and their risk factors. Hum Reprod. 2011;26(7):1741-51. http://doi.org/ckn5sw.
McPherson K, Metcalfe MA, Herbert A, Maresh M, Casbard A, Hargreaves J, et al. Severe complications of hysterectomy: the VALUE study. BJOG. 2004;111(7):688-94. http://doi.org/bbgzj6.
Querleu D, Chapron C, Chevallier L, Bruhat MA. Complications of Gynecologic Laparoscopic Surgery -- A French Multicenter Collaborative Study. N Engl J Med. 1993;328(18):1355. http://doi.org/dqt48q.
Donnez O, Jadoul P, Squifflet J, Donnez J. A series of 3190 laparoscopic hysterectomies for benign disease from 1990 to 2006: evaluation of complications compared with vaginal and abdominal procedures. BJOG. 2009;116(4):492-500. http://doi.org/cv7mg3.
Tian YF, Lin YS, Lu CL, Chia CC, Huang KF, Shih TY, et al. Major complications of operative gynecologic laparoscopy in southern Taiwan: a follow-up study. J Minim Invasive Gynecol. 2007;14(3):284-92. http://doi.org/c7j6sr.
Martino MA, Berger EA, McFetridge JT, Shubella J, Gosciniak G, Wejkszner T, et al. A comparison of quality outcome measures in patients having a hysterectomy for benign disease: robotic vs. non-robotic approaches. J Minim Invasive Gynecol. 2014;21(3):389-93. http://doi.org/f538s4.
Müller A, Thiel FC, Renner SP, Winkler M, Häberle L, Beckmann MW. Hysterectomy-a comparison of approaches. Dtsch Arztebl Int. 2010;107(20):353-9. http://doi.org/cnhz.
Daugbjerg SB, Cesaroni G, Ottesen B, Diderichsen F, Osler M. Effect of socioeconomic position on patient outcome after hysterectomy. Acta Obstet Gynecol Scand. 2014;93(9):926-34. http://doi.org/cnh3.
Recari E, Oroz LC, Lara JA. Complicaciones de la cirugía ginecológica. Anales Sist Sanit Navarra. 2009;32 (Suppl1):65-79. http://doi.org/d34958.
Jaiyeoba O. Postoperative infections in obstetrics and gynecology. Clin Obstet Gynecol. 2012;55(4):904-13. http://doi.org/f4dhc4.
Stany MP, Farley JH. Complications of gynecologic surgery. Surg Clin North Am. 2008;88(2):343-59. http://doi.org/b247c7.
Gilmour DT, Dwyer PL, Carey MP. Lower urinary tract injury during gynecologic surgery and its detection by intraoperative cystoscopy. Obstet Gynecol. 1999;94(5 Pt 2):883-9. http://doi.org/cnh4.
Lee JS, Choe JH, Lee HS, Seo JT. Urologic Complications Following Obstetric and Gynecologic Surgery. Korean J Urol. 2012;53(11):795-9. http://doi.org/cnh5.
Valle L, Seara S, García JÁ. Efectos adversos en la intervención de la histerectomía. Registro informatizado 2002-2003. Rev Calidad Asistencial. 2005;20(4):193-8.
Teeluckdharry B, Gilmour D, Flowerdew G. Urinary Tract Injury at Benign Gynecologic Surgery and the Role of Cystoscopy: A Systematic Review and Meta-analysis. Obstet Gynecol. 2015;126(6):1161-9. http://doi.org/f7zvxb.
Vakili B, Chesson RR, Kyle BL, Shobeiri SA, Echols KT, Gist R, et al. The incidence of urinary tract injury during hysterectomy: A prospective analysis based on universal cystoscopy. Am J Obstet Gynecol. 2005;192(5):1599-604. http://doi.org/dzcmtz.
Ibeanu OA, Chesson RR, Echols KT, Nieves M, Busangu F, Nolan TE. Urinary Tract Injury During Hysterectomy Based on Universal Cystoscopy. Obstet Gynecol. 2009;113(1):6-10. http://doi.org/cnh6.
Olsen MA, Higham-Kessler J, Yokoe DS, Butler AM, Vostok J, Stevenson KB, et al. Developing a risk stratification model for surgical site infection after abdominal hysterectomy. Infect Control Hosp Epidemiol. 2009;30(11):1077-83. http://doi.org/bt5z4t.
Dimensions
PlumX
Visitas a la página del resumen del artículo
Descargas
Cómo citar
Licencia
Derechos de autor 2018 Revista de la Facultad de Medicina
Esta obra está bajo una licencia Creative Commons Reconocimiento 3.0 Unported.
-
