Fatores que impactam em internação prolongada nos pacientes submetidos a cirurgias ortopédicas de membros inferiores no Hospital Universitário de Santa Maria
Ano de defesa: | 2023 |
---|---|
Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | , |
Tipo de documento: | Dissertação |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Universidade Federal de Santa Maria
Centro de Ciências da Saúde |
Programa de Pós-Graduação: |
Programa de Pós-Graduação em Ciências da Saúde
|
Departamento: |
Ciências da Saúde
|
País: |
Brasil
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | http://repositorio.ufsm.br/handle/1/30178 |
Resumo: | Introduction: Orthopedic trauma is one of the most morbid conditions, often surgically treated, which compromises the individual's function, economic participation and social integration. Falls from heights constitute an important problem in the elderly and fractures, especially of the femur, which can lead to complications, including death. The main cause of lower limb fractures in young people are traffic accidents, with motorcycles being responsible for the highest number of cases. Prolonged hospitalization presents complications for the patient's quality of life, increasing the risk of morbidity and mortality, resulting in an increase in hospital costs. Objective: It is important to identify factors that impact prolonged hospitalization in patients undergoing lower limb orthopedic surgeries at the HUSM. Method: This is a cross-sectional, descriptive study. All patients/caregivers who agreed to participate in the research were interviewed to obtain data prior to hospitalization and trauma kinematics. Data on hospitalization were analyzed using the electronic medical record of the AGHU system, with a time frame from July/2021 to March/2022 and daily inclusion of patients. Results: Of the 182 patients evaluated, 25.3% had a length of stay within the average for Rio Grande do Sul (7 days). There was a higher prevalence of male patients (65.9%). Comorbidities and risk factor with statistical significance in patients with prolonged hospitalization were SAH (p<0.001), smoking (p=0.031), diabetes (p<0.001), dyslipidemia (p=0.013) and osteoporosis (p=0.004). Among the fractures, 45.1% femur fractures, 19.8% tibia fractures, 15.4% tibia and fibula fractures, 9.3% malleolar fracture (ankle). Motorcycle accidents had the highest percentage of patients (29.1%), followed by falls from heights (23.1%), falls from standing heights (18.7%), car accidents (10.4%), being run over (9 .8%), gunshot wounds (4.4%), stab wounds (1.6%) and blunt trauma (2.7%). Regarding canceled surgeries, 37 out of 182 surgeries were canceled at least once. Conclusion: For the most part, patients had a prolonged hospitalization time for several reasons, other than those inherent to their clinical condition. When we analyzed age, trauma mechanism, presence of femur fracture or comorbidities, none was significant in relation to the mean length of hospital stay. On the other hand, infection requiring the use of antibiotics and clinical complications in the pre- or postoperative period, exposed fractures and surgery cancellations had a significant impact on the number of days in hospital. It is essential to identify, at the time of admission, patients at risk of delay in discharge, who need complex discharge planning, monitoring situations considered at risk. Continuous knowledge of surveillance indicators is necessary to reduce pre/postoperative infections, as well as indicators of people and material/surgical room management to avoid unnecessary suspension of surgeries due to lack of planning or physical or human material. |
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2023-09-05T15:06:55Z2023-09-05T15:06:55Z2023-08-21http://repositorio.ufsm.br/handle/1/30178Introduction: Orthopedic trauma is one of the most morbid conditions, often surgically treated, which compromises the individual's function, economic participation and social integration. Falls from heights constitute an important problem in the elderly and fractures, especially of the femur, which can lead to complications, including death. The main cause of lower limb fractures in young people are traffic accidents, with motorcycles being responsible for the highest number of cases. Prolonged hospitalization presents complications for the patient's quality of life, increasing the risk of morbidity and mortality, resulting in an increase in hospital costs. Objective: It is important to identify factors that impact prolonged hospitalization in patients undergoing lower limb orthopedic surgeries at the HUSM. Method: This is a cross-sectional, descriptive study. All patients/caregivers who agreed to participate in the research were interviewed to obtain data prior to hospitalization and trauma kinematics. Data on hospitalization were analyzed using the electronic medical record of the AGHU system, with a time frame from July/2021 to March/2022 and daily inclusion of patients. Results: Of the 182 patients evaluated, 25.3% had a length of stay within the average for Rio Grande do Sul (7 days). There was a higher prevalence of male patients (65.9%). Comorbidities and risk factor with statistical significance in patients with prolonged hospitalization were SAH (p<0.001), smoking (p=0.031), diabetes (p<0.001), dyslipidemia (p=0.013) and osteoporosis (p=0.004). Among the fractures, 45.1% femur fractures, 19.8% tibia fractures, 15.4% tibia and fibula fractures, 9.3% malleolar fracture (ankle). Motorcycle accidents had the highest percentage of patients (29.1%), followed by falls from heights (23.1%), falls from standing heights (18.7%), car accidents (10.4%), being run over (9 .8%), gunshot wounds (4.4%), stab wounds (1.6%) and blunt trauma (2.7%). Regarding canceled surgeries, 37 out of 182 surgeries were canceled at least once. Conclusion: For the most part, patients had a prolonged hospitalization time for several reasons, other than those inherent to their clinical condition. When we analyzed age, trauma mechanism, presence of femur fracture or comorbidities, none was significant in relation to the mean length of hospital stay. On the other hand, infection requiring the use of antibiotics and clinical complications in the pre- or postoperative period, exposed fractures and surgery cancellations had a significant impact on the number of days in hospital. It is essential to identify, at the time of admission, patients at risk of delay in discharge, who need complex discharge planning, monitoring situations considered at risk. Continuous knowledge of surveillance indicators is necessary to reduce pre/postoperative infections, as well as indicators of people and material/surgical room management to avoid unnecessary suspension of surgeries due to lack of planning or physical or human material.Introdução: O trauma ortopédico é uma das condições mais mórbidas, de tratamento muitas vezes cirúrgico, que compromete a função do indivíduo, sua participação econômica e sua integração social. Quedas de própria altura constituem um agravo importante nos idosos e fraturas, principalmente de fêmur, as quais podem levar a complicações, inclusive à morte. Já a causa principal de fratura de membros inferiores em jovens são acidentes de trânsito, sendo a motocicleta responsável pelo maior número de casos. Objetivo: A internação prolongada apresenta complicativos para a qualidade de vida do paciente, aumentando risco de morbimortalidade, incidindo aumento dos custos hospitalares. É importante identificar fatores que impactam em internação prolongada nos pacientes submetidos a cirurgias ortopédicas de membros inferiores no HUSM. Método: Trata-se de estudo de coorte, prospectivo, unicêntrico. Todos os pacientes/cuidadores concordantes em participar da pesquisa foram entrevistados, para obter dados prévios à internação e cinemática do trauma. Dados sobre internação hospitalar foram analisados por meio de prontuário eletrônico do sistema AGHU, com recorte temporal de julho/2021 a março/2022 e inclusão diária dos pacientes. Resultados: Dos 182 pacientes avaliados, 25,3% apresentaram tempo de internação dentro da média do Rio Grande do Sul (7 dias). Houve maior prevalência de pacientes do sexo masculino (65,9%). As comorbidades e fator de risco com significância estatística em pacientes com internação prolongada foram HAS (p<0,001), tabagismo (p=0,031), diabetes (p<0,001), dislipidemia (p=0,013) e osteoporose (p=0,004).Dentre as fraturas, observou-se 45,1% fraturas de fêmur, 19,8% fraturas de tíbia, 15,4% fraturas de tíbia e fíbula, 9,3% fratura maleolar (tornozelo). Acidente de motocicleta apresentou maior porcentagem de pacientes (29,1%), seguido de queda de altura (23,1%), queda da própria altura (18,7%), acidente automobilístico (10,4%), atropelamento (9,8%), ferimento por arma de fogo (4,4%), ferimento por arma branca (1,6%) e traumas contusos (2,7%). Acerca das cirurgias canceladas, 37 das 182 cirurgias foram suspensas pelo menos uma vez. Conclusão: Em sua maioria, pacientes apresentaram um prolongamento do tempo de internação por diversas razões, que não as inerentes a sua condição clínica. Quando analisamos idade, mecanismo do trauma, presença de fratura de fêmur ou comorbidades, nenhum foi significativo em relação ao tempo médio de internação hospitalar. Em contrapartida, infecção com necessidade de uso de antibióticos e complicações clínicas no pré ou pós-operatório, fraturas expostas e suspensão de cirurgias tiveram um impacto significativo quando ao número de dias internados. É fundamental identificar no momento da admissão os pacientes com risco de atraso na alta, que necessitem de um planejamento de alta complexo, monitorizando-se situações consideradas de risco. O conhecimento contínuo de indicadores de vigilância faz-se necessário para a redução de infecções pré/pós-operatórias, bem como de indicadores de gestão de pessoas e materiais/salas cirúrgicas para evitar suspensão desnecessária de cirurgias por falta de planejamento ou material físico ou humano.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESporUniversidade Federal de Santa MariaCentro de Ciências da SaúdePrograma de Pós-Graduação em Ciências da SaúdeUFSMBrasilCiências da SaúdeAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessHospitalizaçãoProcedimentos ortopédicosExtremidade inferiorComplicações intraoperatóriasHospitalizationOrthopedic proceduresBottom endIntraoperative complicationsCNPQ::CIENCIAS DA SAUDEFatores que impactam em internação prolongada nos pacientes submetidos a cirurgias ortopédicas de membros inferiores no Hospital Universitário de Santa MariaFactors that impact in prolonged hospitalization in patients submitted to lower limb orthopedic surgery at Hospital Universitário de Santa Mariainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisBeck, Maristela de Oliveirahttp://lattes.cnpq.br/5466354015919916Ribeiro, Tiango AguiarLampert, Melissa AgostiniBrondani, Juliana Eblinghttp://lattes.cnpq.br/0192960584118112Dalla Lana, Daniela400000000001600600600600600600bbbabd09-6e2a-41b2-9620-6ee13ecef722b2aee2d0-7ab1-4bc2-b6fb-f58bcf84991941aa3341-d967-401c-b1ad-f1b2cf078013c57b729f-6229-4d54-ba59-937842ea810266b07e91-7b1e-4023-a626-403e834213adreponame:Manancial - Repositório Digital da UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMORIGINALDIS_PPGCS_2023_DALLA_LANA_DANIELA.pdfDIS_PPGCS_2023_DALLA_LANA_DANIELA.pdfDissertaçãoapplication/pdf1186740http://repositorio.ufsm.br/bitstream/1/30178/1/DIS_PPGCS_2023_DALLA_LANA_DANIELA.pdf3936b1ec37d621003453268ad6c825a4MD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; 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dc.title.por.fl_str_mv |
Fatores que impactam em internação prolongada nos pacientes submetidos a cirurgias ortopédicas de membros inferiores no Hospital Universitário de Santa Maria |
dc.title.alternative.eng.fl_str_mv |
Factors that impact in prolonged hospitalization in patients submitted to lower limb orthopedic surgery at Hospital Universitário de Santa Maria |
title |
Fatores que impactam em internação prolongada nos pacientes submetidos a cirurgias ortopédicas de membros inferiores no Hospital Universitário de Santa Maria |
spellingShingle |
Fatores que impactam em internação prolongada nos pacientes submetidos a cirurgias ortopédicas de membros inferiores no Hospital Universitário de Santa Maria Dalla Lana, Daniela Hospitalização Procedimentos ortopédicos Extremidade inferior Complicações intraoperatórias Hospitalization Orthopedic procedures Bottom end Intraoperative complications CNPQ::CIENCIAS DA SAUDE |
title_short |
Fatores que impactam em internação prolongada nos pacientes submetidos a cirurgias ortopédicas de membros inferiores no Hospital Universitário de Santa Maria |
title_full |
Fatores que impactam em internação prolongada nos pacientes submetidos a cirurgias ortopédicas de membros inferiores no Hospital Universitário de Santa Maria |
title_fullStr |
Fatores que impactam em internação prolongada nos pacientes submetidos a cirurgias ortopédicas de membros inferiores no Hospital Universitário de Santa Maria |
title_full_unstemmed |
Fatores que impactam em internação prolongada nos pacientes submetidos a cirurgias ortopédicas de membros inferiores no Hospital Universitário de Santa Maria |
title_sort |
Fatores que impactam em internação prolongada nos pacientes submetidos a cirurgias ortopédicas de membros inferiores no Hospital Universitário de Santa Maria |
author |
Dalla Lana, Daniela |
author_facet |
Dalla Lana, Daniela |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Beck, Maristela de Oliveira |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/5466354015919916 |
dc.contributor.advisor-co1.fl_str_mv |
Ribeiro, Tiango Aguiar |
dc.contributor.referee1.fl_str_mv |
Lampert, Melissa Agostini |
dc.contributor.referee2.fl_str_mv |
Brondani, Juliana Ebling |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/0192960584118112 |
dc.contributor.author.fl_str_mv |
Dalla Lana, Daniela |
contributor_str_mv |
Beck, Maristela de Oliveira Ribeiro, Tiango Aguiar Lampert, Melissa Agostini Brondani, Juliana Ebling |
dc.subject.por.fl_str_mv |
Hospitalização Procedimentos ortopédicos Extremidade inferior Complicações intraoperatórias |
topic |
Hospitalização Procedimentos ortopédicos Extremidade inferior Complicações intraoperatórias Hospitalization Orthopedic procedures Bottom end Intraoperative complications CNPQ::CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
Hospitalization Orthopedic procedures Bottom end Intraoperative complications |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE |
description |
Introduction: Orthopedic trauma is one of the most morbid conditions, often surgically treated, which compromises the individual's function, economic participation and social integration. Falls from heights constitute an important problem in the elderly and fractures, especially of the femur, which can lead to complications, including death. The main cause of lower limb fractures in young people are traffic accidents, with motorcycles being responsible for the highest number of cases. Prolonged hospitalization presents complications for the patient's quality of life, increasing the risk of morbidity and mortality, resulting in an increase in hospital costs. Objective: It is important to identify factors that impact prolonged hospitalization in patients undergoing lower limb orthopedic surgeries at the HUSM. Method: This is a cross-sectional, descriptive study. All patients/caregivers who agreed to participate in the research were interviewed to obtain data prior to hospitalization and trauma kinematics. Data on hospitalization were analyzed using the electronic medical record of the AGHU system, with a time frame from July/2021 to March/2022 and daily inclusion of patients. Results: Of the 182 patients evaluated, 25.3% had a length of stay within the average for Rio Grande do Sul (7 days). There was a higher prevalence of male patients (65.9%). Comorbidities and risk factor with statistical significance in patients with prolonged hospitalization were SAH (p<0.001), smoking (p=0.031), diabetes (p<0.001), dyslipidemia (p=0.013) and osteoporosis (p=0.004). Among the fractures, 45.1% femur fractures, 19.8% tibia fractures, 15.4% tibia and fibula fractures, 9.3% malleolar fracture (ankle). Motorcycle accidents had the highest percentage of patients (29.1%), followed by falls from heights (23.1%), falls from standing heights (18.7%), car accidents (10.4%), being run over (9 .8%), gunshot wounds (4.4%), stab wounds (1.6%) and blunt trauma (2.7%). Regarding canceled surgeries, 37 out of 182 surgeries were canceled at least once. Conclusion: For the most part, patients had a prolonged hospitalization time for several reasons, other than those inherent to their clinical condition. When we analyzed age, trauma mechanism, presence of femur fracture or comorbidities, none was significant in relation to the mean length of hospital stay. On the other hand, infection requiring the use of antibiotics and clinical complications in the pre- or postoperative period, exposed fractures and surgery cancellations had a significant impact on the number of days in hospital. It is essential to identify, at the time of admission, patients at risk of delay in discharge, who need complex discharge planning, monitoring situations considered at risk. Continuous knowledge of surveillance indicators is necessary to reduce pre/postoperative infections, as well as indicators of people and material/surgical room management to avoid unnecessary suspension of surgeries due to lack of planning or physical or human material. |
publishDate |
2023 |
dc.date.accessioned.fl_str_mv |
2023-09-05T15:06:55Z |
dc.date.available.fl_str_mv |
2023-09-05T15:06:55Z |
dc.date.issued.fl_str_mv |
2023-08-21 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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masterThesis |
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http://repositorio.ufsm.br/handle/1/30178 |
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http://repositorio.ufsm.br/handle/1/30178 |
dc.language.iso.fl_str_mv |
por |
language |
por |
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400000000001 |
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600 600 600 600 600 600 |
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Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
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Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências da Saúde |
dc.publisher.program.fl_str_mv |
Programa de Pós-Graduação em Ciências da Saúde |
dc.publisher.initials.fl_str_mv |
UFSM |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
Ciências da Saúde |
publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências da Saúde |
dc.source.none.fl_str_mv |
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