Prognostic factors of postoperative dissatisfaction: a cohort study
Abstract
Introduction. Patient satisfaction is a priority due to its relationship with the quality of care provided. The incidence and prognostic factors associated with patient satisfaction are uncertain in the Colombian setting.
Objective. To estimate whether sex, age, fasting hours, time scheduled for surgery, surgery cancellation, socioeconomic status, and length of stay are prognostic factors of patient dissatisfaction.
Methods. A historical cohort study was conducted at the Hospital Alma Máter de Antioquia, Medellín, Colombia. Adult patients undergoing elective non-cardiac surgery who completed the EVAN-G or EVAN-RG satisfaction survey and had a corresponding anesthesia record were included. Postoperative dissatisfaction was defined as a score <50 in any dimension of the EVAN scale. Independent variables included demographic, clinical, and perioperative factors. Data were obtained from satisfaction surveys and electronic medical records. The analysis included descriptive statistics, Bayesian inference, multivariable logistic regression, and model evaluation with multiple imputation. Analyses were performed using R and WinBUGS.
Results. A total of 1,201 patients were recruited between July 2020 and October 2023. The incidence of overall dissatisfaction was 2.16% (95% CI: 1.5%; 3.2%). In contrast, the incidence of a certain level of dissatisfaction was 47.46% (95% CI: 44.74%; 50.29%). Independent factors were age (OR 0.94; 95% CI: 0.94–1.00), female sex (OR 1.49; 95% CI: 1.19–1.88), and hospital setting (OR 0.67; 95% CI: 0.45–0.99).
Conclusions. Age and sex are predictors of postoperative dissatisfaction. Further studies are needed to determine prognostic models adapted to the Colombian context.
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