Factors associated with the length of hospital stay of women undergoing cesarean section

Abstract

OBJECTIVE: To evaluate whether age group, complications or comorbidities are associated with the length of hospitalization of women undergoing cesarean section. METHODS: A cross-sectional study was carried out between June 2012 and July 2017, with 64,437 women undergoing cesarean section and who did not acquire conditions during their hospital stay. Hospital discharge data were collected from national health institutions, using the Diagnosis-Related Groups system (DRG Brasil). The DRG referring to cesarean section with additional complications or comorbidities (DRG 765) and cesarean section without complications or associated comorbidities (DRG 766) were included in the initial diagnosis. The influence of age group and comorbidities or complications present at admission on the length of hospital stay was assessed based on the means of the analysis of variance. The size of the effect was verified by Cohen’s D, which allows evaluating clinical relevance. The criticality levels were identified using the Duncan test. RESULTS: The longest length of hospital stay was observed in the age group from 15 to 17 years old and among those aged 45 years old or more. The hospital stay of women with complications or comorbidities at the time of admission was also longer. Moreover, it was noted that the increase in criticality level was associated with an increase in the mean length of hospital stay. CONCLUSIONS: The length of hospital stay of women is higher among those belonging to the age group ranging from 15 to 17 years old and for those aged 45 years old or more. The presence of associated comorbidities, such as eclampsia, pre-existing hypertensive disorder with superimposed proteinuria and gestational hypertension (induced by pregnancy) with significant proteinuria increase the length of hospital stay. This study enabled the construction of distinct criticality level profiles based on the combination of age groups and the main comorbidities, which were directly related to the length of hospital stay.

Postoperative pain management after cesarean delivery: cross-sectional study

“…The epidemiological profile of patients undergoing cesarean delivery in Brazil has changed. The current incidence of late pregnancies has increased, 5 as corroborated by this study, as most of the participants were over 30 years of age. The rise in maternal age is associated with higher perioperative and gestational risks, 5 and requires more attention from health professionals.…”

Time-to-recovery After Cesarean Section Delivery Among Women who Gave birth through Cesarean Section at Hawassa University Comprehensive Specialized Hospital, south Ethiopia: A Prospective Cohort Study

“…We found that the mean time-to-recovery among women whose age were ≤ 30 and ≥ 31 years was 2.75 and 5.69 days respectively (Log rank test = 11.357,P = 0.001). The same nding was reported by different studies where younger women were discharged earlier [3,11,17,18]. This might be due to the fact that, an increased age has been associated with different comorbidities which affects the length of stay at hospital.…”

“…Similarly women who had had and had not had chronic disease had statistically signi cant difference in the recovery times (Log-rank test = 12.445, P < 0.001). This result is supported by different studies; the hospital stay of women with complications and comorbidities was longer [1,15,17,18]. This is due to the reason that women with complications and/or with co-morbities needs additional service for the mnagement.…”

“…On the other hand, our study found that the median (IQR) time of recovery-time was 2.00 (2,3) days. This is corroborated by studies conducted outside Ethiopia, where the avarage of the women were discharged within 2 days [13,17]. However, the nding of this study was inconsistent with other study conducted in Ethiopia: Butajira and Attat hospitals where the mean recovery time was 3.27 [12] and a study conducted in 30 low and mid-income countries showed that the mean (± SD) hospitalization after cesarean section was 5.9 (± 3.4) days in the studied localities [18].…”

Atenção individual e coletiva à saúde materna e infantil no cenário brasileiro

“…No tocante a pré-eclâmpsia, as gestantes que apresentam probabilidade de evoluir para a síndrome de HELLP são igualmente favorecidas com o parto antecipado (BERNARDES et al, 2019). Pereira et al (2019), inferiu que gestantes submetidas à cesariana, sejam jovens ou com idade maior ou igual a 45 anos, passam mais dias em internamento hospitalar. Dentre as afecções que aumentam destacaram-se a eclampsia, o distúrbio hipertensivo prévio com proteinúria superposta e a hipertensão gestacional com presença de proteinúria.…”