ปัจจัยทำนายการเข้ารับการรักษาในหอผู้ป่วยวิกฤตหลังผ่าตัดของผู้บาดเจ็บหลังการผ่าตัดด่วน

Chosigawan Maneechot; Wallada Chanruangvanich; Prangtip Chayaput; Kris Keorochana

Authors

Chosigawan Maneechot Faculty of Nursing, Mahidol University
Wallada Chanruangvanich Faculty of Nursing, Mahidol University
Prangtip Chayaput Faculty of Nursing, Mahidol University
Kris Keorochana Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University.

Keywords:

surgical site, preoperative consciousness level, preoperative shock, perioperative estimated blood loss, postoperative ICU admission, trauma patients, urgent surgery

Abstract

Objective: To study the predictive power of the surgical site, preoperative consciousness level, preoperative shock, perioperative estimated blood loss, and length of operation on urgentsurgery trauma patients’ need for post-operative admission to the ICU
Design: Retrospective predictive correlation design
Methodology: This study was conducted on a sample of 427 trauma patients aged 18 and above at a super-tertiary hospital in Bangkok. The patients were treated in the Emergency and Trauma Department before being transferred to the Urgent Surgery Ward. Data were collected between 1 January 2017 and 31 December 2019, using forms to record the demographic and clinical data, surgical site, consciousness level, shock index, perioperative estimated blood loss, length of operation, and details of postoperative ICU admission. Chi-square and binary logistic regression were employed for statistical analyses, with the level of signifcance set at .05.
Results: Male trauma patients formed the majority of the sample (80.56%). Of these, about half (42.15%) needed postoperative ICU admission. The factors identifed as being capable of signifcantly predicting the need for ICU admission included the surgical site, preoperative consciousness level, preoperative shock, and perioperative estimated blood loss, with a combined predictive power of 68% (Nagelkerke R2 = .68, p < .05).
Recommendations: It is recommended that nurses and multidisciplinary healthcare teams apply the factors of surgical site, preoperative consciousness level, preoperative shock, and perioperative estimated blood loss to determining the need for ICU treatment, to make most effective use of the ICU availability.

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