지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.88 No.6
- 발행연도
- 2015.5
- 수록면
- 311 - 317 (7page)
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초록· 키워드
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Purpose: This study was designed to determine the factors affecting completion of critical pathway for elective gastrectomy.
Methods: Since 2008, a critical pathway has been applied for elective gastrectomy at Chosun University Hospital. We retrospectively analyzed 252 patients who underwent elective gastrectomies from January 2009 to April 2013. The completion rate was determined, and risk factors for patient dropout were examined.
Results: The completion rate of the critical pathway was 45.6% (115/252). Mean length of stay was 11.7 ± 8.6 days (8?59 days). Readmission rates were 4.4% (11/252). Causes of failure for clinical pathway were systemic complications (21/137, 15.3%), intra-abdominal complications (44/137, 32.8%), patient factors (41/137, 29.9%), and wound complications (30/137, 21.9%). There were no significant differences between the two groups in age, sex, American Society of Anesthesiologists (ASA) score, operation time, readmission, and underlying disease (P > 0.05). Body mass index (P = 0.008) and pathologic stage (P = 0.001) were significantly different between the two groups. In multivariate analysis, the conventional approach (odds ratio, 2.0), and total gastrectomy (odds ratio, 5.3) were determined to be independent risk factors to drop the critical pathway. But there were no significant differences between total and distal gastrectomy groups in age, gender, underlying diseases, ASA score, readmission, operation time, and cause of dropout (P > 0.05).
Conclusion: We concluded that total gastrectomy may not be suitable for the critical pathway. We suggest that the critical pathway for elective distal gastrectomy is divided 2 subgroups, according to the surgical approach.
Methods: Since 2008, a critical pathway has been applied for elective gastrectomy at Chosun University Hospital. We retrospectively analyzed 252 patients who underwent elective gastrectomies from January 2009 to April 2013. The completion rate was determined, and risk factors for patient dropout were examined.
Results: The completion rate of the critical pathway was 45.6% (115/252). Mean length of stay was 11.7 ± 8.6 days (8?59 days). Readmission rates were 4.4% (11/252). Causes of failure for clinical pathway were systemic complications (21/137, 15.3%), intra-abdominal complications (44/137, 32.8%), patient factors (41/137, 29.9%), and wound complications (30/137, 21.9%). There were no significant differences between the two groups in age, sex, American Society of Anesthesiologists (ASA) score, operation time, readmission, and underlying disease (P > 0.05). Body mass index (P = 0.008) and pathologic stage (P = 0.001) were significantly different between the two groups. In multivariate analysis, the conventional approach (odds ratio, 2.0), and total gastrectomy (odds ratio, 5.3) were determined to be independent risk factors to drop the critical pathway. But there were no significant differences between total and distal gastrectomy groups in age, gender, underlying diseases, ASA score, readmission, operation time, and cause of dropout (P > 0.05).
Conclusion: We concluded that total gastrectomy may not be suitable for the critical pathway. We suggest that the critical pathway for elective distal gastrectomy is divided 2 subgroups, according to the surgical approach.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (18)
참고문헌 신청
[학술지(정기간행물)] - Rotter T. / 2012 / The effects of clinical pathways on professional practice, patient outcomes, length of stay, and hospital costs : Cochrane systematic review and meta-analysis / Eval Health Prof 35 : 3 ~ 27
[학술지(정기간행물)] - Zhang M. / 2014 / The application of clinical pathways in laparoscopic cholecystectomy / Hepatobiliary Pancreat Dis Int 13 : 348 ~ 353
[학술지(정기간행물)] - Saint S. / 2003 / Use of critical pathways to improve efficiency : a cautionary tale / Am J Manag Care 9 : 758 ~ 765
[학술지(정기간행물)] - Nussbaum DP. / 2015 / A standardized care plan is associated with shorter hospital length of stay in patients undergoing pancreaticoduodenectomy / J Surg Res 193 : 237 ~ 245
[학술지(정기간행물)] - Ho Seok Seo / 2012 / The Impact of an Increased Application of Critical Pathway for Gastrectomy on the Length of Stay and Cost / Journal of Gastric Cancer 12 (2) : 126 ~ 131
[학술지(정기간행물)] - Zhang M. / 2014 / The application of clinical pathways in laparoscopic cholecystectomy / Hepatobiliary Pancreat Dis Int 13 : 348 ~ 353
[학술지(정기간행물)] - Saint S. / 2003 / Use of critical pathways to improve efficiency : a cautionary tale / Am J Manag Care 9 : 758 ~ 765
[학술지(정기간행물)] - Nussbaum DP. / 2015 / A standardized care plan is associated with shorter hospital length of stay in patients undergoing pancreaticoduodenectomy / J Surg Res 193 : 237 ~ 245
[학술지(정기간행물)] - Ho Seok Seo / 2012 / The Impact of an Increased Application of Critical Pathway for Gastrectomy on the Length of Stay and Cost / Journal of Gastric Cancer 12 (2) : 126 ~ 131
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UCI(KEPA) : I410-ECN-0101-2016-514-001512194