Perfil clínico-epidemiológico del paciente ostomizado en un Centro Hospitalario de alta complejidad

Abstract

Objective: The creation of an ostomy is a surgical procedure that is performed regularly in the operating rooms of all hospitals nationwide, regardless of their level of care, constituting a valuable tool among the techniques of colorectal surgery, both oncological and emergency. Its characteristics will vary according to the profile of the population served in each institution. Methods: this is an observational, descriptive, retrospective study, in which the patients who underwent an intestinal ostomy at the Edgardo Rebagliati Martins Hospital in the period 2017 – 2018 were taken as the population. A review of the medical records of the operated patients, using a file where their demographic and epidemiological data were recorded, as well as the information related to the surgery, including the indications for the ostomy, its morphology and complications. Finally, a descriptive statistical analysis was performed based on the frequency distribution of the variables with the IBM SPSS version 23 program. Results: the information of 73 ostomies made during the study period was accessed. The average age of the population was 68.67 } 14 years, with the majority of patients being female (63%). The main reason for admission was a previous diagnosis of cancer (58%), mainly of colorectal origin, being the risk of concurrent intestinal obstruction and fistulization to neighboring organs, secondary to the neoproliferative process or radiation treatment, the main surgical indications (45 , 9% and 17.8% respectively). An average hospital stay of 28.31 } 7.4 days was recorded. Loop ostomy (80.8%) was the most frequent type, mainly at the level of the transverse colon (78.1%), being more frequently located towards the upper left quadrant of the abdomen (30.1%). Thirty two complications were recorded in 24 cases (32.9%), the most frequent being those related to surgery (ileus, surgical site infection, etc.), reported in 13 of them (54.2%). The complication most commonly associated with the ostomy was edema, observed in 5 patients (20.8%), followed by prolapse, described in 3 (12.5%). Conclusions: ostomy patients in highly complex hospitals like ours have particular characteristics that largely determine the course and outcome of their hospital stay, such as the presence of advanced age, with multiple associated comorbidities and whose main indication for surgery is the presence of risk of obstruction due to colorectal cancer. A broad interdisciplinary management and patient-focused approach protocols are required, based on a previously developed clinicalepidemiological profile, which optimizes the medical care to be provided.