Predictive model for length of hospital stay of patients surviving surgery for perforated peptic ulcer. 2009

Chin-Hsien Li, and Ming-Jong Bair, and Wen-Hsiung Chang, and Shou-Chuan Shih, and Shee-Chan Lin, and Ching-Ying Yeh
Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.

OBJECTIVE Many studies have assessed the major risk factors for mortality or morbidity in surgical patients with perforated peptic ulcer (PPU). The aim of our study was to focus on survivors and to investigate the predictive factors for length of hospital stay (LOHS) for surgical patients. METHODS The medical records of 195 patients who survived surgery were reviewed retrospectively. The following factors were analyzed: patient profile, associated medical illnesses, diagnostic methods, fever, preoperative shock, clinical data from the emergency room, delays in surgery, sites of perforation, operative methods, positive ascites culture and species of microorganism, postoperative infection, and noninfective postoperative complications. RESULTS Univariate analysis showed that the following factors were significantly related to longer LOHS: age > 65 years, liver cirrhosis, diabetes mellitus, history of peptic ulcer disease, number of comorbid diseases, preoperative shock, creatinine > 1.5 mg/dL, surgical delay of > 12 hours, and all postoperative factors except species of microorganisms in ascites culture. In a multivariate linear regression model, catheter infection, pneumonia, urinary tract infection, wound infection, bacteremia, non-infective abdominal complications, other infections, surgical delay of > 12 hours, and comorbidity were major factors associated with longer LOHS. CONCLUSIONS A predictive model was established with nine factors that explained 71.6% of the variation in LOHS of patients who survived surgery for PPU. Several corrective methods based on the model can be devised by attending physicians to shorten LOHS.

UI MeSH Term Description Entries
D007902 Length of Stay The period of confinement of a patient to a hospital or other health facility. Hospital Stay,Hospital Stays,Stay Length,Stay Lengths,Stay, Hospital,Stays, Hospital
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010439 Peptic Ulcer Perforation Penetration of a PEPTIC ULCER through the wall of DUODENUM or STOMACH allowing the leakage of luminal contents into the PERITONEAL CAVITY. Peptic Ulcer Perforations,Perforation, Peptic Ulcer,Perforations, Peptic Ulcer,Ulcer Perforation, Peptic,Ulcer Perforations, Peptic
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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