Short length of stay and the discharge process: Preparing breast cancer patients appropriately

Background While obesity is thought to increase complication rates in general surgery procedures, its effect in mastectomy patients remains to be fully elucidated. We sought to determine if obesity is associated with a higher complication rate and length of stay after mastectomy, independent of clinicopathologic and treatment factors. Methods Medical records of breast cancer patients undergoing mastectomy at our institution between January 2010 and December 2017 were retrospectively reviewed. Patients were separated into obese (body mass index [BMI] ≥ 30) and nonobese (BMI < 30) categories and compared using nonparametric statistical analyses. Results Of 927 patients, 291 (31.2%) were obese. Obese patients had more complications (26.5% vs. 20.0%, P = 0.033) and a greater number of complications per patient ( P = 0.025) than nonobese patients. They were more likely to have infections (10.7% vs. 5.7%, P = .009), flap thrombosis/necrosis (5.5% vs. 2.4%, P = .018), and skin breakdown/wound complications (8.6% vs. 4.6%, P = .022). Additionally, obese patients had longer hospital length of stay (LOS; LOS > 2 days: 77.7% vs. 65.2%, P < .001). Controlling for potential confounders, obesity remained associated with a higher rate of thrombosis/necrosis of flap (odds ratio [OR] = 2.26; 95% confidence interval [CI] 1.01-5.08; P = .047) and LOS ≥ 2 days (OR = 1.82; 95% CI 1.23-2.69; P = .003). Conclusion Obese breast cancer patients undergoing mastectomy have more thrombosis/necrosis of flap and a longer hospital LOS than nonobese patients, regardless of other comorbidities and clinicopathologic/treatment factors.

Download Full-text

ANALISIS LAMA RAWAT INAP PASIEN KANKER PAYUDARA YANG MENJALANI PEMBEDAHAN MASTEKTOMI DI RUMAH SAKIT UMUM PUSAT (RSUP) SANGLAH TAHUN 2016

ARCHIVE OF COMMUNITY HEALTH ◽

10.24843/ach.2018.v05.i02.p03 ◽

2018 ◽

Vol 5 (2) ◽

pp. 18

Author(s):

Debby Amanda Putri Tarigan ◽

Ni Made Dian Kurniasari ◽

Ketut Hari Mulyawan

Keyword(s):

Breast Cancer ◽

Length Of Stay ◽

Cancer Patients ◽

General Hospital ◽

Significant Relationship ◽

Cox Regression ◽

Statistical Tests ◽

Simple Random Sampling ◽

Breast Cancer Patients ◽

Kaplan Meier

ABSTRAK Di Indonesia jenis kanker tertinggi yang diderita wanita adalah kanker payudara dengan angka kejadian 2,2% dari 1000 perempuan (Depkes RI, 2012). Salah satu jenis pengobatan yang dapat dilakukan pasien kanker adalah dengan melakukan pembedahan mastektomi sehingga pasien harus rawat inap. Tujuan penelitian ini untuk mengetahui lama rawat inap pasien kanker payudara yang menjalani pembedahan masektomi dan faktor yang mempengaruhinya di Rumah Sakit Umum Pusat Sanglah. Penelitian ini dilakukan di Rumah Sakit Umum Pusat Sanglah. Desain penelitian menggunakan analitik kohort retrospektif. Sebanyak 89 sampel penelitian yaitu pasien yang menjalani pembedahan mastektomi di Rumah Sakit Umum Pusat Sanglah pada tahun 2016 diambil secara acak sederhana. Pengumpulan data berasal dari catatan rekam medis pasien. Analisis data dilakukan dengan uji statistik Kaplan Meier, Log Rank dan Regresi Cox. Hasil penelitian menunjukkan median lama rawat inap pasien kanker payudara yang menjalani pembedahan mastektomi di RSUP Sanglah Denpasar tahun 2016 adalah 9 hari. Hasil analisis menunjukkan adanya hubungan yang bermakna antara tingkat stadium pasien kanker payudara (HR=7,19 , 95%CI= 2,88-17,95) dan riwayat kemoterapi yang dilakukan pasien (HR = 5,47 , 95%CI = 3,12-9,59) terhadap lama rawat inap pasien kanker payudara yang menjalani pembedahan mastektomi, serta dari penelitian ini dapat dilihat bahwa tidak ada hubungan yang bermakna antara umur (HR= 1,37, 95%CI = 0,85-2,21) dan ukuran tumor (HR=2.63, 95%CI= 0,79-8,68) terhadap lama rawat inap pasien kanker payudara yang menjalani pembedahan mastektomi. Kata kunci: Kanker Payudara, Lama Rawat Inap, Pembedahan Mastektomi ABSTRACT In Indonesia the highest type of cancer suffered by women is breast cancer with an incidence rate of 2.2% of 1000 women (Depkes RI, 2012). One type of treatment that can be done by cancer patients is by performing a mastectomy surgery so that patients must be hospitalized. The purpose of this study was to determine the length of stay of breast cancer patients undergoing masectomy surgery and the factors that influenced it at Sanglah Central General Hospital. This research was conducted at the Sanglah Central General Hospital. The study design used a retrospective cohort analytic. A total of 89 study samples, namely patients who underwent mastectomy surgery at Sanglah Central General Hospital in 2016, were taken by simple random sampling. Data collection comes from the patient's medical record. Data analysis was performed with Kaplan Meier statistical tests, Log Rank and Cox Regression. The results showed the median length of stay for breast cancer patients undergoing mastectomy surgery at Sanglah Hospital Denpasar in 2016 was 9 days. The analysis showed a significant relationship between the stage of breast cancer patients (HR = 7.19, 95% CI = 2.88-17.95) and the history of chemotherapy performed by patients (HR = 5.47, 95% CI = 3 , 12-9,59) to the length of stay of breast cancer patients undergoing mastectomy surgery, and from this study it can be seen that there is no significant relationship between age (HR = 1.37, 95% CI = 0.85-2, 21) and tumor size (HR = 2.63, 95% CI = 0.79-8.68) to the length of stay of breast cancer patients undergoing mastectomy surgery. Keywords: Breast Cancer, Length of Hospitalization, Mastectomy Surgery

Download Full-text