Readmissões hospitalares não planejadas de pacientes submetidos à cirurgia oncológica em um hospital regional do Tocantins

Abstract

Introduction: cancer patients undergoing oncological surgery may suffer frequent readmissions due to their health condition. The complexity of the disease and surgical complications can lead to several complications and the outcome death is the worst condition that can occur. Studies on cancer patients can help elucidate important aspects of the readmission process of people who have had oncological surgery. Research on the subject is still rare due to the complexity involved in the topic. Thus, knowing the factors associated with the death of this population will certainly contribute to the implementation of prevention strategies and higher quality of care for cancer patients undergoing oncological surgery. Objective: to evaluate the frequency of readmissions of patients undergoing oncological surgeries and the factors associated with the death of these patients. Methods: Analytical cross- sectional study, with secondary data collection in medical records of patients undergoing oncological surgeries from January 2019 to January 2022. The present investigation was conducted between January and August 2022, when all information was consulted for database construction. Data were extracted regarding the variables of exposure (sociodemographic and clinical data) and outcome (death). A descriptive analysis was performed, estimating absolute and relative frequencies. In addition, measures of central tendency and dispersion were calculated. Univariate and multivariate analysis by means of logistic regression to evaluate the factors of associates on the outcome of interest. Odds Ratio (OR) and respective 95% confidence intervals were measured. Results were considered significant with p<0.05. Research approved by the ethics committee, opinion number 5.171.255. Results: 163 medical records of cancer patients who underwent surgery and were readmitted were selected. In the first hospitalization there was a higher proportion of female patients (52.8%), aged between 41 and 59 years (43.6%), single (50.9%), living in urban areas (92.6%), in the state of Tocantins (95.1%). During the first readmission, 4.3% of the patients were admitted to the ICU; The most common complications/complications were abdominal pain, wound infection, intestinal obstruction and fever. For 52.1% of the patients, the time between discharge and readmission was 30 to 360 days; The main cause of the first readmission was treatment by surgery. Variables associated with death were: being admitted to the intensive care unit during readmission (OR: 7.63; CI95%:1.42 - 41.11, p=0.018) and being readmitted for surgical surgery (OR: 12.39; CI95%:1.52- 100.68, p=0.019). Conclusion: patients submitted to surgical procedure are predominantly female, young, single, residents of the urban area and Tocatins. Few patients were hospitalized and most had complications. Those who were admitted to the intensive care unit during readmission had a higher chance of death. The results of this research can contribute to the improvement of care for cancer patients, as they present an overview of the clinical profile of these patients and, with this, will provide the formulation of a protocol more directed to the care needs of this public