Postoperative complications in patients with disabling psychiatric illnesses or intellectual handicaps. A case-controlled, retrospective analysis.

The purpose of this study was to quantitate the operative risk and costs encountered in the surgical treatment of institutionalized patients. Operative complications and duration of hospitalization for 200 institutionalized patients were compared with those in a control group of patients matched for age, sex, and type of operation drawn from the general hospital population. Postoperative complications occurred in 53 (26.5%) of the patients in the study group compared with 15 (7.5%) of the patients in the control group. Elective laparotomy was followed by a complication in 48% of institutionalized patients compared with 11.6% of matched controls. Emergency celiotomy carried a 75% complication rate in the study group. Atelectasis and pneumonia accounted for 50% of the postoperative complications and occurred with greatest frequency following intra-abdominal procedures. The median hospital stay for all institutionalized patients was 3 days more than for matched controls. A strategy for postoperative treatment is presented, with particular emphasis on prevention of pulmonary complications.

本研究的目的是量化收容住院患者手术治疗中所面临的手术风险和费用。将200名收容住院患者的手术并发症和住院时间与从综合医院人群中选取的年龄、性别和手术类型相匹配的对照组患者进行了比较。研究组中有53名（26.5%）患者发生术后并发症，而对照组中为15名（7.5%）。选择性剖腹手术后，收容住院患者中有48%发生并发症，而匹配的对照组为11.6%。研究组中急诊剖腹手术的并发症发生率为75%。肺不张和肺炎占术后并发症的50%，且在腹腔内手术后发生频率最高。所有收容住院患者的中位住院时间比匹配的对照组多3天。提出了一种术后治疗策略，特别强调预防肺部并发症。