RÉSUMÉ
PURPOSE: In response to external pressure to achieve an idealized length of stay after colon resection, a study was designed to define perioperative factors that significantly impact average length of stay (ALOS). METHODS: We retrospectively reviewed the records of 226 patients undergoing open colon resection from 1988 to 1995 to determine the effects of age, type of procedure, nature of the procedure (elective vs. emergency), and postoperative course on ALOS. Statistics were calculated by Student's t-test, chi-squared analysis, and analysis of variance. RESULTS: Average length of stay was 10 (range, 4-34) days, with a significant trend toward lower ALOS in recent years; ALOS in 1988 averaged 11 days, whereas in 1994, ALOS averaged 9 days (r2 = 0.118; P < 0.001). Patients younger than 65 years of age had an ALOS of 9 days vs. 11 days in patients older than 65 years (P = 0.0024). Patients with anastomoses on the right and left side had similar ALOS (8.5 vs. 9.1 days), whereas creation of a stoma was associated with a significantly higher ALOS (12.1 days; P < 0.00001). The need for postoperative nasogastric intubation (14.9 vs. 9.3 days) and the performance of emergency operations (12.2 vs. 6.5 days) were also associated with a significantly higher ALOS (P < 0.00001). CONCLUSIONS: Caution must be exercised in accepting rigid criteria for length of stay for patients undergoing colorectal resections, as uncontrollable clinical variables are involved in defining the "ideal" patient.
Sujet(s)
Colectomie , Durée du séjour , Facteurs âges , Sujet âgé , Analyse de variance , Anastomose chirurgicale/méthodes , Anastomose chirurgicale/statistiques et données numériques , Colectomie/méthodes , Colectomie/statistiques et données numériques , Rectocolite hémorragique/chirurgie , Tumeurs du côlon/chirurgie , Colostomie/statistiques et données numériques , Maladie de Crohn/chirurgie , Diverticulite colique/chirurgie , Interventions chirurgicales non urgentes , Urgences , Hospitalisation , Humains , Intubation gastro-intestinale/statistiques et données numériques , Durée du séjour/statistiques et données numériques , Massachusetts/épidémiologie , Analyse multifactorielle , Soins postopératoires , Analyse de régression , Études rétrospectivesRÉSUMÉ
Normal values for respiratory resistance were determined by means of the oscillation method in 257 children and adolescents of both sexes aged 3--17 years. Respiratory resistance, measured by both the oscillatory and plethysmographic method, increased in inverse proportion to body height, body weight, body surface and age. Normal values can be estimated by means of the equation: y = 14.51--0.064X (X = hight in centimetres).