Desenlaces clínicos del cuidado perioperatorio de reemplazos articulares según grupos relacionados de diagnóstico en un hospital de cuarto nivel

Abstract

Introduction Related Groups of Diagnosis (RGD) have been used to determine the attention quality in different health systems, which have contributed to the improvement of patients’ care and attention. The aim of this study is to determine clinical outcomes of patients who have had joint replacement according to the clinical complexity defined by RGD. Methods The method used for this study was a longitudinal descriptive, which included all patients who had shoulder, hip and knee surgery replacement between 2012 and 2014. The stratification of patients was made according to three levels of complexity given by the RGD system. In addition, the study determined the proportions of patients for hospitalization variables, like thromboembolic disease, cardiovascular, and surgical site infection. Results Forty (4.5%) of the total 886 articulation replacements presented complications. The most common events were coronary complications, with a presence of 2.4%. RGD1, without complications or comorbidities, presented the most events. The hospital stay was 3.8 to 9.3 days for all replacements.

Conclusions Contrary to what was stated in the study hypothesis, we found that the first RGD had the highest number of complications, which can be related to the size of the group. Further research is necessary to support the use of RGD as a tool for assessing outcomes.