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Risk factors for postoperative complications after fast-track abdominal hysterectomy
Linköping University, Department of Medical and Health Sciences, Anesthesiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping.
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
2012 (English)In: Australian and New Zealand journal of obstetrics and gynaecology, ISSN 0004-8666, E-ISSN 1479-828X, Vol. 52, no 2, 113-120 p.Article in journal (Refereed) Published
Abstract [en]

Background: Fast-track regimen has been shown to reduce postoperative complications in gastrointestinal surgery. less thanbrgreater than less thanbrgreater thanAims: We investigated the incidence and type of postoperative complications and associated risk factors after benign abdominal hysterectomy undertaken in a fast-track program. less thanbrgreater than less thanbrgreater thanMethods: A prospective longitudinal cohort study. In five Swedish hospitals, a cohort of 162 women, ASA 1-2, undergoing abdominal hysterectomy in a fast-track program was prospectively studied. Surgery was performed under spinal or general anaesthesia. The fast-track concept was standardised with discharge criteria and a restricted intravenous fluid regimen. Complications were systematically registered during the five-week follow-up period. Risk factors for complications were analysed using multiple logistic regression models. less thanbrgreater than less thanbrgreater thanResults: Forty-one (25.3%) developed postoperative complications, mainly infection and wound healing complications. The majority of the complications developed after discharge and were treated in the outpatient clinics. Four women (2.5%) were readmitted to hospital. Substantial risk factors for postoperative complications were obesity (OR 8.83), prior laparotomy (OR 2.92) and relative increase in body weight on the first postoperative day (OR 1.52). less thanbrgreater than less thanbrgreater thanConclusions: Minor infection and wound healing complications seem to be common in healthy women undergoing abdominal hysterectomy in a fast-track program. Obesity is an important risk factor also in fast-track abdominal hysterectomy. A modest increase in postoperative relative weight gain during the first postoperative day seemed to increase the risk of postoperative complications. This factor merits further study. Randomised studies are necessary to determine the impact of fast-track program and perioperative fluid regimens on postoperative complications.

Place, publisher, year, edition, pages
Wiley-Blackwell , 2012. Vol. 52, no 2, 113-120 p.
Keyword [en]
fast track, hysterectomy, postoperative complications, risk factors
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-76946DOI: 10.1111/j.1479-828X.2011.01395.xISI: 000302233100003OAI: oai:DiVA.org:liu-76946DiVA: diva2:524368
Note

Funding Agencies|Medical Research Council of South East Sweden; Linkoping University||County Council of Ostergotland||

Available from: 2012-05-02 Created: 2012-04-27 Last updated: 2017-12-07

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Nilsson, LenaBorendal Wodlin, NinnieKjölhede, Preben

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Nilsson, LenaBorendal Wodlin, NinnieKjölhede, Preben
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AnesthesiologyFaculty of Health SciencesDepartment of Anaesthesiology and Intensive Care in LinköpingDepartment of Clinical and Experimental MedicineObstetrics and gynecologyDepartment of Gynaecology and Obstetrics in Linköping
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Australian and New Zealand journal of obstetrics and gynaecology
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