Outcomes After Nonobstetric Surgery in Pregnant Patients: A Nationwide Study

被引:20
作者
Huang, Shih-Yu [1 ,2 ]
Lo, Po-Han [1 ,2 ]
Liu, Wei-Min [3 ,4 ]
Cherng, Yih-Giun [1 ,2 ]
Yeh, Chun-Chieh [5 ,6 ]
Chen, Ta-Liang [2 ,7 ,8 ]
Liao, Chien-Chang [2 ,7 ,8 ,9 ]
机构
[1] Shuang Ho Hosp, Dept Anesthesiol, New Taipei, Taiwan
[2] Taipei Med Univ, Sch Med, Dept Anesthesiol, Taipei, Taiwan
[3] Taipei Med Univ Hosp, Dept Obstet & Gynecol, Taipei, Taiwan
[4] Taipei Med Univ, Coll Med, Sch Med, Dept Obstet & Gynecol, Taipei, Taiwan
[5] China Med Univ Hosp, Dept Surg, Taichung, Taiwan
[6] Univ Illinois, Dept Surg, Chicago, IL 60680 USA
[7] Taipei Med Univ Hosp, Dept Anesthesiol, 252 Wuxing St, Taipei 110, Taiwan
[8] Taipei Med Univ Hosp, Ctr Hlth Policy Res, Taipei, Taiwan
[9] China Med Univ, Sch Chinese Med, Taichung, Taiwan
关键词
POSTOPERATIVE ADVERSE OUTCOMES; POPULATION-BASED-COHORT; TRAUMATIC BRAIN-INJURY; NONCARDIAC SURGERY; BREAST-CANCER; ACUTE APPENDICITIS; NONPREGNANT WOMEN; MANAGEMENT; RISK; CHOLECYSTECTOMY;
D O I
10.1016/j.mayocp.2016.06.021
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Objective: To evaluate outcomes after nonobstetric surgical procedures in pregnant patients. Methods: We conducted a retrospective cohort study of 5591 pregnant women who underwent nonobstetric surgical procedures using Taiwan's National Health Insurance Research Database 2008-2012 claims data. Using a propensity score matching procedure, 22,364 nonpregnant women were selected for comparison. Logistic regression was used to calculate the odds ratios (ORs) and 95% CIs of postoperative complications and in-hospital mortality associated with pregnancy. Results: Pregnant women had higher risks of postoperative septicemia (OR = 1.75; 95% CI, 1.47-2.07), pneumonia (OR = 1.47; 95% CI, 1.01-2.13), urinary tract infection (OR = 1.29; 95% CI, 1.08-1.54), and in-hospital mortality (OR = 3.94; 95% CI, 2.62-5.92) compared with nonpregnant women. Pregnant women also had longer hospital stays and higher medical expenditures after nonobstetric surgical procedures than controls. Higher rates of postoperative adverse events in pregnant women receiving nonobstetric surgery were noted in all age groups. Conclusion: Surgical patients with pregnancy showed more adverse events, with a risk of in-hospital mortality approximately 4-fold higher after nonobstetric surgery compared with nonpregnant patients. These findings suggest the urgent need to revise the protocols for postoperative care for this population. (C) 2016 Mayo Foundation for Medical Education and Research
引用
收藏
页码:1166 / 1172
页数:7
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