Health Science Clinical Research

Treatment Outcomes after Anterior Cervical Discectomy and Fusion (ACDF) Surgery in Patients Treated at Roi Et Hospital : A 3-Months Post-operative Analysis

2025-08-21T15:49:59+07:00

Objective: To evaluate treatment outcomes and identify factors associated with the modified Japanese Orthopaedic Association (mJOA) Recovery Rate in patients who underwent anterior cervical discectomy and fusion (ACDF) within a 3-month postoperative period.
Methods: Medical records of 61 patients who underwent ACDF between January 2013 and April 2025 were reviewed. Data collected included demographic information, preoperative and postoperative clinical characteristics, and 3-month postoperative outcomes. Descriptive statistics, univariate analysis, and multivariate logistic regression were performed, with statistical significance set at p < 0.05.
Results: Among the 61 patients, most were male (70.49%) with a mean age of 60.07 years (SD = 8.07). Prior to surgery, the majority had moderate mJOA scores (77.05%), with C5–C6–C7 being the most common surgical level (26.23%). At 3 months postoperatively, most patients improved to mild mJOA scores (65.57%). Neck Disability Index (NDI) was mostly in the mild category (61.40%). Patient satisfaction with outcomes was reported in 67.21%, and 73.77% were able to return to work. Factors significantly associated with a recovery rate < 50% included body mass index (BMI) of 25–29.90 kg/m², preoperative mJOA score < 11, symptom duration longer than 76–100 weeks, and multilevel (≥3 levels) fusion.
Conclusions: Most patients demonstrated favorable clinical outcomes within 3 months after ACDF, with improvement in mJOA score to the mild category and NDI within the mild range. The majority were satisfied with the surgical outcomes and were able to return to work. However, poorer recovery rate was observed in patients with higher BMI, lower preoperative mJOA scores, longer symptom duration, and multilevel fusion. Early surgical intervention, especially in patients with low mJOA scores, along with weight management and long-term follow-up, is recommended. Further studies are warranted to identify additional prognostic factors for optimizing patient care.

Risk Factors for Impaired Outcomes After Surgery in Patients With Spontaneous Intracerebral Hemorrhage

2025-09-19T17:59:41+07:00

Objective: To investigate prognostic factors for mortality and morbidity in patients with hemorrhagic stroke who underwent surgical treatment at Phichit Hospital.
Methods: This prognostic study was conducted as a retrospective cohort of patients aged over 18 years who underwent surgical treatment for intracerebral hemorrhage at Phichit Hospital between October 1, 2020, and May 31, 2024. Prognostic factors were analyzed using logistic regression.
Results: A total of 201 patients were included. The overall mortality rate was 29.9%. Among survivors, the morbidity rate was as high as 86.52%. Factors significantly associated with mortality included low initial level of consciousness (Glasgow Coma Scale, GCS ≤5), coagulopathy, warfarin use, comorbidities (chronic kidney disease/atrial fibrillation), and postoperative complications such as sepsis and acute kidney injury (AKI). Factors associated with morbidity included age over 60 years, hematoma volume ≥30 mL, dyslipidemia, and postoperative infections (pneumonia and urinary tract infection).
Conclusions: Early identification and close monitoring of high risk patients such as those with impaired consciousness, coagulopathy, or major comorbidities together with strict prevention of postoperative infections, are crucial strategies to reduce mortality and improve patient outcomes. These prognostic factors may also serve as valuable information for providing prognostic counseling to patients’ families before and after surgery.

Development of Nursing Practice Guideline for Monitoring Adverse Events among Outpatients waiting for Treatment at Thongsaenkhan Hospital

2025-09-05T16:07:52+07:00

Objective: To study the situation of adverse events occurring while waiting for treatment in the Outpatient Department of Thongsaenkhan Hospital. Develop a nursing practice guideline for monitoring adverse events while waiting for treatment in the Outpatient Department.
Methods: The research and development (R&D) study was conducted over a over a four-month period, from May to August 2025. The study participants included 11 registered nurses working in the outpatient department of Thongsaenkhan Hospital, Uttaradit Province, who were selected through purposive and voluntary sampling. In addition, patients who voluntarily agreed to participate were recruited at the waiting area of the outpatient department of Thongsaenkhan Hospital, Uttaradit Province. The sample size was determined using Krejcie and Morgan’s table, resulting in a total of 287 participants. Data were collected through a questionnaire and analyzed using content analysis, frequency, percentage, mean, standard deviation, the Wilcoxon signed-rank test, and the One-sample t-test.
Results: After the implementation, the study revealed that the participants’ mean satisfaction with nursing practice guidelines for monitoring adverse symptoms while waiting for treatment was ≥85%, with statistical significance at p<0.001. Most participants reported a high level of satisfaction with the outpatient nursing services at Thongsaenkhan Hospital, Uttaradit Province, accounting for 91.40%. The comparison of mean waiting times, measured from card submission at the examination room to the time of returning home, showed that prior to the development, the average waiting time was 81 minutes (1 hour and 21 minutes), whereas after the development, the waiting time decreased to 53 minutes. Regarding the service providers, registered nurses demonstrated a high level of knowledge concerning the monitoring of adverse symptoms while waiting for treatment, accounting for 99.09%, with a mean score of 19.82, which was significantly higher than before the development (p<0.001). The response time to changes in symptoms before and after implementing the nursing practice guideline for monitoring adverse symptoms decreased from an average of 19.63 minutes to 12.21 minutes, representing a 37.80% reduction. This finding indicates an improvement in the efficiency of patient care.
Conclusion: The results of this study on the development of nursing practice guidelines for monitoring adverse symptoms while waiting for treatment in the outpatient department of Thongsaenkhan Hospital demonstrated improved efficiency in patient care. The guidelines enabled healthcare personnel to respond more promptly to patients’ adverse symptoms.

The Outcome of Nursing for Monitoring the Deteriorating Symptoms of Patients in the Observation Room at Uttaradit Hospital

2025-10-02T16:22:33+07:00

Objective: To examine the effects of nursing interventions for monitoring deterioration in patients admitted to the observation room at Uttaradit Hospital.
Methods: A quasi-experimental study using a two-group posttest design was conducted with prospective data collection. A purposive sampling method was applied to select 240 patients, divided into two groups: Control group: Patients monitored for deterioration between September and November 2023 (n=120) and Experimental group: Patients monitored for deterioration between December 2023 and February 2024 (n=120). Research instruments included 1) A general patient information questionnaire 2)
A deterioration monitoring assessment using the Modified Early Warning Score (MEWS), validated through IOC and Cronbach’s alpha reliability testing. Data were analyzed using frequency, percentage, mean, standard deviation, and t-test.
Results: Most patients were female (56.67%) and aged over 60 years (45%). The most common comorbidity was diabetes mellitus (18.33%), followed by hyperlipidemia (14.17%). The most frequent presenting symptom was abdominal pain (20%). Comparison of nursing outcomes
using MEWS showed that the experimental group achieved safe care outcomes, with patients discharged home (Mean = 3.19, SD = 0.70), at a significantly higher level than the control group (p<0.01). The average observation time was 1–2 hours (Mean=3.35, SD=1.08), which differed significantly from the control group (p<0.001).
Conclusion: Nursing interventions for monitoring deterioration using MEWS were significantly more effective than standard care (p<0.001). This approach prevented patient deterioration, enhanced safety, reduced the risk of critical events, and clearly supported the quality of nursing care in observation rooms.