A study on risk factors and survival of respiratory failure for patients who performed after Head Surgery
| Autor: | Hsiao-Ping Kuo, 郭小萍 |
|---|---|
| Rok vydání: | 2012 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 100 Most of the previous researches reveal that cardiac chest abdominal surgery was a popular topic for the economical effect of postoperative respiratory failure complications in hospitalization. However, the influence that different head injury categories caused is still unclear. In this study, the purpose is divided into three parts and includes: 1) to estimate the risk factors that brain surgery causes respiratory failure (RF), 2) hos-pitalization care costs of the different head injury and 3) the probability that different head trauma categories cause RF. According to 2004 National Health Insurance Research Database (NHIRD), the 3536 patients that received brain surgery due to head injury are as the studied objects of this thesis and are divided into two groups including “study” and “control.” “study” means that the patients occurred RF after brain surgery, but “control” means that the patients didn’t occur RF after brain surgery. “study” and “control” which proportion is one to three according to gender, age, and RUB (Resource Utilization Bands). The re-search method is as follows: 1) Logistic regression and generalized linear model are used to study the risk factors of respiratory failure complications and the dependence of “study” and hospitalization case costs. 2) Kaplan-Meier curve is used to compare the cases that different head injury categories cause respiratory failure complications. 3) The risk factors between different head injury categories and RF are investigated with cox proportional-hazard model. Compared with “control” data, “study” data shows the higher hospitalization ex-penses, adjusted costs of general wards and intensive care units (ICU) costs, and the longer hospitalization days, ICU days and ventilator days. Furthermore, RF risk factors include chronic lung disease, fluid and electrolyte imbalance. Mental disease is a risk factor that RF is induced by brain surgery. Head injury categories are intracerebral hemorrhage (ICH) that other injuries caused. The probability that other injuries (853.854) caused RF is higher than that of other head injury categories. Increase of hospitalization costs is dependent on “study” and ICH that other injuries caused (853.854). Moreover, Kaplan-Meier curve apparently shows the probability that all the injured situations in-duced RF is around 20 %. The probability of ICH that other injuries (853.854) caused and RF that intracerebral injury caused is higher than that of other categories. RF that fractures of the skull bottom (801) caused is the lowest probability. Therefore, to estimate early nursing interventions with preoperative risk assessment not only reduces the incidence of respiratory failure complications but also lowers the postoperative RF incidence and medical care costs. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
| Externí odkaz: |
|