Complejidad operatoria y patrones quirúrgicos en cirugía abdominal hospitalaria
DOI:
https://doi.org/10.70577/rps.v4i1.187Palabras clave:
Complejidad operatoria, cirugía abdominal, patrones quirúrgicos, riesgo perioperatorio, resultados clínicos.Resumen
La cirugía abdominal hospitalaria presenta una elevada variabilidad en los desenlaces clínicos debido a la interacción de múltiples factores asociados a la complejidad operatoria, lo que dificulta la estandarización del desempeño quirúrgico y la optimización de resultados. El objetivo fue analizar la complejidad operatoria y los patrones quirúrgicos en función de variables técnicas, procedimentales y asistenciales. Se desarrolló un estudio cuantitativo, no experimental, retrospectivo y de alcance analítico, basado en la revisión de informes técnicos y bases de datos internacionales, aplicando estadística descriptiva, regresión logística multinivel y análisis de conglomerados jerárquicos. Los resultados evidencian predominio de cirugías electivas (68.5 %), mientras que las urgentes concentran mayor mortalidad (8.9 %) y riesgo clínico (OR = 2.47). La complejidad operatoria alta se posiciona como el principal predictor de eventos adversos (OR = 2.84), seguida de la duración quirúrgica mayor a 4 horas (OR = 1.96), comorbilidad múltiple (OR = 1.72) y edad superior a 65 años (OR = 1.58). La tasa de complicaciones alcanza el 29.7 %, con estancia hospitalaria promedio de 7.6 días y reingresos del 11.3 %. Se identifican tres patrones quirúrgicos diferenciados según nivel de complejidad, duración y desenlaces, evidenciando una estructura no aleatoria del comportamiento quirúrgico. Se establece que la complejidad operatoria actúa como eje central del riesgo y puede ser parcialmente modulada mediante intervenciones perioperatorias.
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Derechos de autor 2026 Dario Gustavo Mora Bazantes, Bedie Olinda Guevara Herbias, Soledad Isla Grados, Feeler Aldahir Palacios Feijoo
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
