The Association between Selected Demographic Data, Postoperative Pain, Anxiety, Complications, Pulmonary Complications and Physiological Recovery of Patients after Major Abdominal Surgery in Critical Stage

Abstract

Purpose: To explore selected factors associated to physiological recovery (the Acute Physiology and Chronic Health Evaluation II: APACHE II) of patients after major abdominal surgery in critical stage.

Design: Descriptive design.

Methods: The sample group consisted of 86 patients undergoing major abdominal surgery (GI system and accessory organs) who had been admitted to the surgical intensive care unit at Chulalongkorn Memorial Hospital, Thailand, from August to December of 2009. Data collection was performed by using demographic assessment form, the numeric rating pain scale, pulmonary complication evaluation form, numeric rating anxiety scale, and the Acute Physiology and Chronic Health Evaluation II (APACHE II) after immediate surgery. Descriptive statistics and chi-square test were used in data analysis.

Main findings: The result showed that majority of patients were male, age range from 18-87 years old (average 62.13±16.45). Seventy one percent of them had co-morbidity include HT, DM, IHD, etc. The pain score averaged 5.08±2.89 to 3.78±2.71 and anxiety score averaged 2.69±2.83 to 2.24±2.88 from 10 scores. 2.3 percent of them found pulmonary complications and 23.3 percent of them found postoperative complications. Most common postoperative complications were HT, arrhythmia, Acute MI, Infection, etc. There were significant association between age, pulmonary complications, postoperative complications and physiological recovery: APACHE II of patients after major abdominal surgery in critical stage (p< .01, .05, and .01, respectively).

Conclusion and recommendations: Awareness regarding age, pulmonary complications, and postoperative complications should be promoted to improve the physiological recovery of patients during the immediate recovery phase.