Phetchabun Medical Journal

Clinical Outcomes and Post-operative Complications Following Liver Resection for Hepatobiliary Tumors at Phetchabun Hospital

Sarawut Bangkhao — 2025-08-29

Hepatobiliary tumors, which have high global incidence and are among the leading causes of cancer-related mortality, often require surgical resection as the mainstay of treatment, offering favorable clinical outcomes. This study aimed to describe the baseline clinical characteristics and tumor types and to evaluate the clinical outcomes and incidence of post-operative complications in patients undergoing hepatic resection in Phetchabun Hospital. This retrospective descriptive study included patients diagnosed with hepatobiliary tumors who underwent hepatic resection at the Department of Surgery, Phetchabun Hospital, between January 2017 and December 2022. Data were collected from electronic medical records and analyzed using standard statistical software. A total of 52 patients were included; 63.4% were male, with a median age of 59.5 years. The most common diagnosis was hepatocellular carcinoma (32.7%), followed by metastatic liver cancer (28.9%) and cholangiocarcinoma (19.2%). The median intraoperative blood loss and operative time were 200 milliliters and 270 minutes, respectively. The median length of hospital stay was 6.5 days. No postoperative mortality was reported. The most common complication was bile leakage, observed in 25 patients (48%), most were classified as grade A according to the International Study Group of Liver Surgery (ISGLS) criteria and resolved without the need for reoperation. In conclusion, hepatic resection at Phetchabun Hospital resulted in favorable clinical outcomes with no post-operative mortality. However, post-operative bile leakage, particularly grade A, was relatively common. Continuous improvement in surgical techniques to minimize this issue and vigilant monitoring for post-operative complications are recommended to further enhance patient outcomes.

Incidence, Associated Factors, and Clinical Prediction Criteria of Septicemia in End-Stage Renal Disease Patients Undergoing Hemodialysis at Wichian Buri Hospital, Phetchabun Province, Thailand

Kwansuphang Wongwatanasanti — 2025-08-29

Septicemia is a major complication among patients with end-stage renal disease (ESRD) receiving hemodialysis. This study aimed to determine the incidence, identify risk factors, and develop a clinical prediction criterion for septicemia in this population. A retrospective cohort study was conducted by reviewing medical records of 149 ESRD patients who underwent hemodialysis at Wichian Buri Hospital between October 2021 and September 2024. Data included demographic characteristics, comorbidities, dialysis duration, type and duration of vascular access, and laboratory parameters. Descriptive statistics and univariate and multivariate logistic regression analyses were performed, with significance defined as p-value <0.05. The overall incidence of septicemia was 18.0 per 100 patient-years, lowest among those with arteriovenous fistula (14.0 per 100 patient-years) and highest in patients with non-tunneled cuffed catheters (115.3 per 100 patient-years). Independent risk factors were hemodialysis performed outside the hospital (Adj. OR 3.54, p=0.003) and serum albumin ≤3.5 mg/dL (Adj. OR 4.34, p=0.002), while age >65 years (Adj. OR 0.27, p=0.004) and hematocrit ≤25% (Adj. OR 0.29, p=0.01) were protective factors. A clinical prediction score derived from β coefficients was established: age >65 years = -1, outpatient dialysis = +1, albumin ≤3.5 mg/dL = +1, and hematocrit ≤25% = -1. The score stratified patients into low, moderate, and high-risk groups. Apparent validation showed the highest AUC of 0.74 at cutoff ≥1. In conclusion, patients with ESRD on hemodialysis have an increased risk of septicemia, particularly those receiving dialysis outside the hospital and with low serum albumin. A clinical prediction criterion may help identify high-risk patients for early prevention, but further validation is needed.

Risk Factors of Teenage Pregnancy on Birth Asphyxia at Phetchabun Hospital

Napatkamon Suphap — 2025-09-08

Teenage pregnancy is a high-risk condition for maternal and neonatal complications, particularly birth asphyxia, which remains a major cause of neonatal morbidity and mortality. This study aimed to identify risk factors associated with birth asphyxia among teenage mothers at Phetchabun Hospital. A retrospective case–control study was conducted using medical records of women aged 10–19 years who delivered between October 1, 2017, and September 30, 2022. A total of 343 cases were included, comprising 69 neonates with birth asphyxia (Apgar score ≤7 at 1 minute) and 274 controls (Apgar score >7). Maternal age, parity, antenatal care attendance, and completion of at least five antenatal visits did not differ significantly between groups (p>0.05). The case group had a higher proportion of preterm births (<37 weeks) than controls (24.6% vs. 12.0%; p=0.008). HIV infection and the use of Prostaglandin for labor induction were more frequent among cases (8.7% vs. 1.8%; p=0.011; 23.2% vs. 10.9%; p=0.008, respectively). Vacuum-assisted deliveries occurred more frequently in the case group (13.0% vs. 5.5%; p=0.036), whereas spontaneous vaginal deliveries were less frequent (37.7% vs. 56.6%; p=0.005). Multivariable analysis identified thalassemia (adjusted OR 9.22; 95% CI 1.11–76.89; p=0.040), HIV infection (adjusted OR 4.18; 95% CI 1.05–16.75; p=0.043), and the use of Prostaglandin (adjusted OR 2.45; 95% CI 1.09–5.48; p=0.030) as independent risk factors for birth asphyxia, all statistically significant. The findings suggested that teenage mothers with these risk factors should be screened early, monitored closely, and managed appropriately regarding labor induction to reduce neonatal complications and improve maternal and child health outcomes.

The Development of Nursing Innovation for Pressure Injury Prevention in Critical Illness Infants

Namthip Bunta — 2025-08-29

Critically ill infants have underdeveloped physical and physiological characteristics, limited mobility, and often require medical devices, which increase their risk of pressure injuries. This study aimed to investigate the challenges and the need for developing a prevention model, design and develop nursing innovations to prevent pressure injuries, compare nurses’ knowledge before and after a workshop, and evaluate the use of these innovations in professional practice. A research and development project was conducted in the neonatal intensive care unit of Phetchabun Hospital from September 2023 to June 2024, comprising three phases: situational analysis, innovation development, and evaluation. Participants included 13 professional nurses and 80 critically ill neonates. Research instruments comprised the nursing innovations, usage and evaluation records, pre–post knowledge assessments, and nurse satisfaction questionnaires. Descriptive statistics were used for general data, Chi-Square for group differences, Fisher’s Exact Test for pressure injury rates before and after innovation use, and paired sample t-test for nurses’ knowledge scores. The findings indicated that critically ill neonates remained at high risk for pressure injuries and lacked concrete preventive innovations. The developed innovations, including a “protective box” and a “nursing practice guideline for pressure injury prevention,” significantly increased nurses’ knowledge (p < 0.001), reduced pressure injury incidence (p = 0.005), and achieved the highest level of nurse satisfaction ( = 4.51, S.D. = 0.34) The study demonstrated that these innovations could reduce pressure injuries, enhance neonatal quality of life and development, establish systematic care approaches, and potentially be scaled to other units and nationwide.