Control de calidad postoperatoria en cirugía ambulatoria.
The growth of Ambulatory Surgery (AS) has been centred in addition of techniques, drugs and procedures that allow increasing to the number of ambulatory operations. This growing must an improvement of the control that allows evaluating the state of the patients at home.
The objective of this work is to define a tool to try to measure post-discharge evolution by a phone answer protocol: the phone score. It is defined as the sum of the qualitative variables that form it.
Material and methods
We made 2027 protocol phone calls with the phone score to 928 patients of the Ambulatory Surgery Unit (ASU) of Hospital Dr Peset of Valencia (Spain). The pre-hospital variables are defined like: age, sex and ASA. Intra-hospital variables: type of operation (speciality and intensity), time of surgery, time of discharge and type of anaesthesia. The intensity of operation is defined like the perceived aggression at home. With the purpose of studying the relationship between the independent answers and pre and intra-hospital variables, is applied a logistic regression with accumulated odds.
In the analysis of the calls is observed that the protocol answer is influenced by: age, sex, specialty, intensity (type of operation) and the type of anaesthesia. According to the statistic analysis, each one of them follows a model. In general it is observed that the answer to the severe pain is of the 7.1%; moderate pain: 21.6% and nauseas in a 10.1% of the patients at home.
It is observed that the variable time of surgery is not significant comparing with the surgical intensity. The design of phone score is able to predict post-discharge evolution
The phone score is an instrument that serves to objectively evaluate the state of domiciliary recuperation of the AS patient. It can influence the models of selecting and treatment improving the yield of the ASU. It is possible to be applied to compare evolution post-discharge of a process of well-known intensity or between different surgical or analgesic treatments.
Advisor:Barberá Alacreu, Manuel; Ayala Gallego, Guillermo
School:Universitat de València
Source Type:Master's Thesis
Date of Publication:01/26/2007