Open medicine (Warsaw, Poland) · 2026
Association of a standardized nursing protocol with postoperative complications following open radical gastrectomy: a retrospective cohort study.
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Yan Na, Hong Qing, Yuan Jinghui, Fei Wei
Аннотация
OBJECTIVES: To evaluate the independent association of a standardized, multi-modal intraoperative nursing protocol on postoperative complications in patients undergoing open radical gastrectomy for gastric cancer.
METHODS: This retrospective cohort study included 89 patients who underwent open radical gastrectomy. Patients were categorized into a standardized care group (n=44) receiving a multi-modal nursing protocol and a non-standardized care group (n=45). The primary outcome was 30-day complications (Clavien-Dindo ≥II). Multivariable logistic regression adjusted for confounders.
RESULTS: A total of 89 patients were included (standardized care group, n=44; non-standardized care group, n=45). The total complication rate was significantly lower in the Standardized Care Group (22.7 % vs. 48.9 %, p<0.01). After adjustment, standardized nursing care was independently associated with reduced complications (adjusted OR=0.32; 95 % CI: 0.12-0.85; p=0.022). Intraoperative hypothermia (OR=3.45; 95 % CI: 1.42-8.38) and operative time ≥200 min (OR=2.89; 95 % CI: 1.18-7.07) were identified as independent risk factors.
CONCLUSIONS: In the context of open gastrectomy, a systematic intraoperative nursing protocol is significantly and independently associated with reduced postoperative morbidity, primarily by being associated with lower rates of procedure-specific risks such as hypothermia and prolonged operative time. This study provides quantitative evidence to support reconceptualizing structured operating room nursing from a supportive role to a core component of therapeutic intervention associated with improved surgical outcomes.
METHODS: This retrospective cohort study included 89 patients who underwent open radical gastrectomy. Patients were categorized into a standardized care group (n=44) receiving a multi-modal nursing protocol and a non-standardized care group (n=45). The primary outcome was 30-day complications (Clavien-Dindo ≥II). Multivariable logistic regression adjusted for confounders.
RESULTS: A total of 89 patients were included (standardized care group, n=44; non-standardized care group, n=45). The total complication rate was significantly lower in the Standardized Care Group (22.7 % vs. 48.9 %, p<0.01). After adjustment, standardized nursing care was independently associated with reduced complications (adjusted OR=0.32; 95 % CI: 0.12-0.85; p=0.022). Intraoperative hypothermia (OR=3.45; 95 % CI: 1.42-8.38) and operative time ≥200 min (OR=2.89; 95 % CI: 1.18-7.07) were identified as independent risk factors.
CONCLUSIONS: In the context of open gastrectomy, a systematic intraoperative nursing protocol is significantly and independently associated with reduced postoperative morbidity, primarily by being associated with lower rates of procedure-specific risks such as hypothermia and prolonged operative time. This study provides quantitative evidence to support reconceptualizing structured operating room nursing from a supportive role to a core component of therapeutic intervention associated with improved surgical outcomes.