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Jung and Park: Comparing the Postoperative Complications, Hospitalization Days and Treatment Expenses Depending on the Administration of Postoperative Prophylactic Antibiotics to Hysterectomy
Original Article

Korean J Women Health Nurs 2017;23(1):42-51.

Published online: 17 March 2017

DOI: https://doi.org/10.4069/kjwhn.2017.23.1.42

Comparing the Postoperative Complications, Hospitalization Days and Treatment Expenses Depending on the Administration of Postoperative Prophylactic Antibiotics to Hysterectomy

Mi Young Jung1, Kyung-Yeon Park2,

1Good Munhwa Hospital, Busan, Korea

2Department of Nursing, Silla University, Busan, Korea

Corresponding author: Park, Kyung-Yeon Department of Nursing, Silla University, 140 Baegyang-daero, 700beon-gil, Sasang-gu, Busan 46958, Korea. Tel: +82-51-999-5461, Fax: +82-51-999-6241, E-mail: kypark@silla.ac.kr

Received 9 September 201621 November 2016       Accepted 26 December 2016

Copyright © 2017 Korean Society of Women Health Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was conducted to compare postoperative complications, hospitalization days and treatment expenses to postoperative prophylactic antibiotics administrated to hysterectomy or not.

Methods

A retrospective survey study was performed with 128 cases in which elective hysterectomy had undergone. They were divided into two groups by identifying whether postoperative prophylactic antibiotics was administered for hysterectomy: a) one group who received postoperative prophylactic antibiotics and; b) those who did not. Data were collected using the electric medical record at a hospital and analyzed by SPSS 23.0 for x2 test, t-test and ANCOVA.

Results

Postoperative complications including wound infection (p=1.000), pneumonia (p=.496), hematoma (p=.530), and pneumoperitoneum (p=.496) showed no significant differences between two groups. Hospitalization days for the prophylactic antibioticsadmin-istrated group were significantly longer than the non-administered for prophylactic antibiotics (p=.004). The treatment expenses of the prophylactic antibiotics-administrated group were significantly higher than those of the non-administered prophylactic antibiotics (F=4.31, p=.040).

Conclusion

These results can be provided for the evidence of administrating postoperative prophylactic antibiotics to hysterectomy. Additionally, it can contribute to decreasing the medication errors caused by infrequently administrating postoperative prophylactic antibiotics as well as to lessening likelihood of infection of intravenous injection site.

Keywords: Postoperative complications, Antibiotics, Hysterectomy

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Table 1.
Homogeneity of Participants' General Characteristics between Two Groups (N=128)
Characteristics Categories No administration group for postoperative prophylactic antibiotics (n=64) Administration group for Postoperative prophylactic antibiotics (n=64) x2 or t p
n (%) or M±SD n (%) or M±SD
Age (yr)   49.88±9.42 47.97±6.73 1.38 .190
Marital status Married 63 (98.4) 60 (93.8)   .365
Single 1 (1.6) 4 (6.3)    
Education† Elementary school ≤ 6 (9.4) 4 (6.3) 1.81 .612
Middle school 3 (4.7) 3 (4.7)    
High school 48 (75.0) 45 (70.3)    
College ≥ 7 (10.9) 12 (18.8)    
Smoking† Yes 2 (3.1) 2 (3.1)   1.000
No 62 (96.9) 62 (96.9)    
Body mass index Underweight 1 (1.6) 3 (4.7) 3.85 .278
Normal 30 (46.9) 31 (48.4)    
Overweight 11 (17.2) 17 (26.6)    
Obesity 19 (29.7) 12 (18.8)    
Choose doctor† Yes 63 (98.4) 60 (93.8)   .365
No 1 (1.6) 4 (6.3)    
Diagnosis Myoma uteri 36 (56.3) 42 (65.6) 1.81 .405
Adenomyosis 23 (35.9) 16 (25.0)    
Others 5 (7.8) 6 (9.4)    

† Fisher's exact test.

Table 2.
Homogeneity of Infection variables related Characteristics between Two Groups (N=128)
Variables No administration group for postoperative prophylactic antibiotics (n=64) Administration group for Postoperative prophylactic antibiotics (n=64) x2 or t p
n (%) or M±SD n (%) or M±SD
Preoperative body temperature () ℃ 36.78±0.19 36.86±0.22 -2.20 .030
Preoperative WBC (10×3/ L) μ 6.29±1.67 6.51±2.57 -0.58 .561
Preoperative neutrophil (%) 61.36±9.94 57.47±8.24 2.41 .017
Preoperative lymphocyte (%) 29.13±8.60 31.85±7.15 -1.95 .053
Duration of NPO (hour) 10.86±2.25 10.92±2.40 -0.15 .879
Duration of operation time (minute) 106.88±31.03 107.89±28.88 -0.19 .848
Diabetes†       .440
Yes 5 (7.8) 2 (3.1)    
No 59 (92.2) 62 (96.9)    
Perioperative transfusion†       1.000
Yes 4 (6.3) 5 (7.8)    
No 60 (93.8) 59 (92.2)    
Type of pain control     1.30 .523
PCA 8 (12.5) 6 (9.4)    
NSAIDs 0 (0.0) 1 (1.6)    
PCA+NSAIDs 56 (87.5) 57 (89.1)    

NPO=nor par os (nothing by mouth); PCA=patient controlled analgesia; NSAIDs=non-steroidal anti-inflammatory drugs;

† Fisher's exact test; WBC=white blood cell count.

Table 3.
Differences in Postoperative Infection related Characteristics by Prophylactic Use of Antibiotics (N=128)
Variables No administration group for postoperative prophylactic antibiotics (n=64) Administration group for Postoperative prophylactic antibiotics (n=64) x2 or F‡ p
n (%) or M±SD n (%) or M±SD
Body temperature () ℃        
POD #1 36.54±4.18 37.27±0.42 1.47 .227
POD #2 37.16±0.42 37.49±0.49 11.45 .001
POD #3 37.14±0.49 37.56±0.59 14.06 .001 ＜
POD #4 37.05±0.43 37.43±0.54 12.87 .001 ＜
WBC of POD #1 (10×3/ L) μ 10.23±2.35 10.46±3.42 0.36 .550
Neutrophil of POD #1 (%) 79.90±6.52 77.02±7.72 4.16 .044
Lymphocyte of POD #1 (%) 13.12±4.82 15.05±6.05 2.84 .094
Number of days to keep drainage tube 2.39±0.81 4.03±1.19 71.11 .001 ＜
at wound site        
Frequency of wound dressing†       .004
Once a day 61 (95.3) 49 (76.6)    
More than once a day 3 (4.7) 15 (23.4)    

† Fisher's exact test; POD=post-operation day;

‡ ANCOVAs were used to identify group differences after controlling for preoperative body temperature and preoperative neutrophil.

Table 4.
Differences of Postoperative Complication and Healthcare Cost by Prophylactic Use of Antibiotics after Operation (N=128)
Variables Categories No administration group for postoperative prophylactic antibiotics (n=64) Administration group for Postoperative prophylactic antibiotics (n=64) x2 or F‡ p
n (%) or M±SD n (%) or M±SD
Surgical wound infection† Yes 3 (4.7) 3 (4.7)   1.000
No 61 (95.3) 61 (95.3)    
Pneumonia† Yes 0 (0.0) 2 (3.1)   .496
No 64 (100.0) 62 (96.9)    
Hematoma† Yes 4 (6.3) 7 (10.9)   .530
No 60 (93.8) 57 (89.1)    
Pneumoperitoneum† Yes 0 (0.0) 2 (3.1)   .496
No 64 (100.0) 62 (96.9)    
Number of days for hospitalization   8.58±1.11 9.89±1.94 15.67 .001 ＜
Cost of treatment (won)   1,086,150±94,700 1,145,580±176,290 4.31 .040

† Fisher's exact test;

‡ ANCOVAs were used to identify group differences after controlling for preoperative body temperature and preoperative neutrophil.

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