ปัจจัยทำนายจำนวนวันนอนโรงพยาบาลของผู้ป่วยที่ได้รับการผ่าตัดหัวใจแบบเปิด

Abstract

Open-heart surgery is a treatment aimed at correcting congenital abnormalities of the heart and acquired heart disease. Trends of patients undergoing heart surgery are currently rising with most patients being adults and elderly people. According to statistics on heart surgery in Thailand, Thailand had 14,769 patients who underwent heart surgery in 2017 and this number increased to 15,368 patients in 2018 (The Society of Thoracic Surgeons of Thailand, 2017). According to Kijjanon & Get-kong (2009), who studied patients who had undergone open-heart surgery at a government hospital in which 69.50 percent of the patients were adult and elderly patients, open-heart surgery was found to have helped patients have good physical, psychological and social quality of life (Suwanakitch et al., 2019; Buttapim, Wanitkun, Sindhu & Kasemsarn, 2018; Sirisatheanrooch, Chittithavorn & Maneewat, 2012). However, patients who have undergone open-heart surgery may have post-operative complications resulting in longer intubation and ICU stays (Bohplian, 2014; Ranucci, Baryshnikova, Castelvecchio & Pelissero, 2013; Eltheni et al., 2012; Almashrafi, Elmontsri & Aylin, 2016; Azarfarin, Ashouri, Totonchi, Bakhshandeh & Yaghoubi, 2014), causing patients to have longer hospital stays and higher treatment costs. The main indicator of care quality for patients who have undergone open-heart surgery is length of hospital stay at a mean of seven days (Hengcharoensuwan, Utriyaprasit, Sindhu & Laksanabunsong, 2010; Buttapim et al., 2018). According to a review of factors related to length of hospital stay among patients after open-heart surgery domestically and abroad, the following two factors were involved: 1) Patients’ factors such as gender, age, diabetes mellitus, ejection fraction and emergency hospital admission; and 2) Surgery factors consisting of type of surgery, Type of urgency, cardiopulmonary bypass time, duration of surgery, postoperative complications (Buttapim et al., 2018; Hengcharoensuwan et al., 2010; Fukfon, Wasee, Duangnakhorn & Akarawanasakun, 2018; Kijjanon & Getkong, 2009; Almashrafi, Alsabti, Mukaddirov, Balan & Aylin, 2016). Patients with long length of hospital stay were found to be more likely to have complications and higher treatment costs. In Thailand, studies have been conducted on the factors related to length of hospital stay among patients in the intensive care unit. Most of the subjects were elderly patients who had received pre-planned coronary artery bypass surgery. However, currently, most of the patients who received open-heart surgery are adult and elderly patients. Few studies were conducted in Thailand. Therefore, the researcher’s interest is in studying the factors predicting length of hospital stay among adult and elderly open-heart surgery patients to create baseline data for developing quality and more effective care models for open-heart surgery patients. Research Objective – To study the factors predicting length of hospital stay in open-heart surgery patients. Scope of the Study – This study is a retrospective research. Data were collected from patients’ medical records. The population was patients who have undergone open-heart surgery at Kasemrad Hospital Prachachuen in 2015 – 2016.