|本期目录/Table of Contents|

[1]郑凯源,王吉,付蔚华.胃癌根治术出院后30 d内非计划再入院的原因及危险因素分析[J].天津医科大学学报,2018,24(03):212-215.
 ZHENG Kai-yuan,WANG Ji,FU Wei-hua.Analysis of risk factors and causes for unplanned readmission for patients with gastric cancer within 30 days after radical gastrectomy[J].Journal of Tianjin Medical University,2018,24(03):212-215.
点击复制

胃癌根治术出院后30 d内非计划再入院的原因及危险因素分析(PDF)
分享到:

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
24卷
期数:
2018年03期
页码:
212-215
栏目:
出版日期:
2018-05-20

文章信息/Info

Title:
Analysis of risk factors and causes for unplanned readmission for patients with gastric cancer within 30 days after radical gastrectomy
作者:
郑凯源王吉付蔚华
天津医科大学总医院普通外科,天津300052
Author(s):
ZHENG Kai-yuan WANG Ji FU Wei-hua
Department of General Surgery, General Hospital, Tianjin Medical University, Tianjin 300052, China
关键词:
胃癌根治术非计划再入院术后并发症危险因素
Keywords:
radical gastrectomy unplanned readmission postoperative complications risk factors
分类号:
R619
DOI:
-
文献标志码:
A
摘要:
目的:探讨胃癌根治术患者出院后30 d内非计划再入院的危险因素及原因。方法:回顾性收集497例行胃癌根治术患者的临床及术中资料,根据出院后是否30 d内非计划再入院分为再入院组(61例)和非再入院组(436例),比较两组患者的临床及术中资料,用多变量Logistic回归分析再入院组的相关危险因素。结果:胃癌根治术后30 d内非计划再入院率为12.2%,比较两组患者临床资料结果显示术前合并症、切除范围、平均住院时间、术后并发症差异具有统计学意义(P<0.05),多变量Logistic回归分析结果表明患者术前合并症(OR=2.56)、切除范围(OR=1.78)、术后并发症(OR=3.24)是出院后30 d内非计划再入院的危险因素,其差异具有统计学意义(P<0.05)。结论:术前合并症、切除范围、术后并发症是胃癌根治术患者出院后30 d内非计划再入院的危险因素,非计划再入院最常见的原因为胃排空延迟和切口感染。
Abstract:
Objective: To investigate risk factors and causes for unplanned readmission within 30 days after radical gastrectomy for patients with gastric cancer. Methods: A retrospective analysis of 497 patients with gastric cancer undergoing radical gastrectomy were performed. These patients were assigned into readmission group (61 cases) and non-readmission group (436 cases) according to whether or not they had been readmitted within 30 days after discharge. By comparing the clinical data of two groups, related risk factors of readmission group were analyzed by multivariate logistic regression models. Results: The incidence of unplanned readmission within 30 days after radical gastrectomy was 12.2%. Comparison of clinical data between the two groups showed that preoperative comorbidities, range of resection, average length of stay, postoperative complications were statistically significant(P<0.05). Multivariate logistic regression analysis showed that preoperative comorbidities (OR=2.56), resection range (OR=1.78) and postoperative complications (OR=3.24) were risk factors for unplanned readmission within 30 days after discharge, and the difference was statistically significant. Conclusion: The preoperative comorbidities, extent of resection and postoperative complications are the risk factors for unplanned readmission within 30 days after discharge. And the most common causes of unplanned readmission after radical gastrectomy are delayed gastric emptying and incision infection.

参考文献/References:

[1] Jencks S F. Defragmenting care[J]. Ann Intern Med, 2010,153(11):757
[2] Kim M C, Kim K H, Jung G J. A 5 year analysis of readmissions after radical subtotal gastrectomy for early gastric cancer[J]. Ann Surg Oncol, 2012,19(8):2459
[3] Schneider E B, Hyder O, Brooke B S, et al. Patient readmission and mortality after colorectal surgery for colon cancer: impact of length of stay relative to other clinical factors[J]. J Am Coll Surg, 2012, 214(4):390
[4] Ansari M Z, Collopy B T, Booth J L. Hospital characteristics associated with unplanned readmissions[J]. Aust Health Rev,1995,18:63
[5] Clavien P A, Barkun J, de Oliveira M L, et al. The Clavien-Dindo    classification of surgical complications: five-year experience[J]. Ann Surg, 2009,250(2):187
[6] Jemal A, Bray F, Center M M, et al. Global cancer statistics[J]. CA Cancer J Clin, 2011, 61(2):69
[7] Telem D A , Chin E H , Nguyen S Q, et al. Risk factors for anastomoticleak following colorectal surgery: a case-control study[J]. Arch Surg, 2010, 145(4):371
[8] Ahmad R, Schmidt B H, Rattner D W, et al. Factors influencing readmission after curativegastrectomy for gastric cancer[J]. J Am CollSurg, 2014,218(6):1215
[9] Kim M C, Kim K H, Jung G J. A 5 year analysis of readmissions after radical subtotal gastrectomy for early gastric cancer[J]. Ann Surg Oncol, 2012, 19(8):2459
[10] Sundaram A, Srinivasan A, Baker S, et al. Readmission and risk factors for readmission following esophagectomy for esophageal cancer[J]. J Gastrointest Surg, 2015,19(4):581
[11] Kent T S, Sachs T E, Callery M P, et al. Readmission after major pancreatic resection: a necessary evil[J]. J Am Coll Surg, 2011, 213(4):515
[12] Kassin M T, Owen R M, Perez S D, et al. Risk factors for 30-day hospital readmission among general surgery patients[J]. J Am Coll Surg, 2012,215(3): 322
[13] Mariette C, De Botton M L, Piessen G. Surgery in esophageal and gastric cancer patients: what is the role for nutrition support in your daily practice[J]. Ann Surg Oncol, 2012, 19(7):2128
[14] Kariv Y, Wang W, Senagore A J, et al. Multivariable analysis of factors associated with hospital readmission after intestinal surgery[J].Am J Surg, 2006 ,191(3):364
[15] Sachdev G, Napolitano L M. Postoperative pulmonary complications: pneumonia and acute respiratory failure[J]. Surg Clin North Am, 2012, 92(2):321
[16] Cheadle W G. Risk factors for surgical site infection[J]. Surg Infect, 2006,7[Suppl 1]:S7
[17] Reddy D M, Townsend C M Jr, Kuo Y F, et al. Readmission after pancreatectomy for pancreatic cancer in medicare patients[J]. J Gastrointest Surg, 2009, 13(11):1963
[18] Jencks S F, Williams M V, Coleman E A. Rehospitalizations among patients in the Medicare fee-for-service program[J]. N Engl J Med, 2009,360(14):1418
[19] Winter J M, Cameron J L, Campbell K A ,et al. 1423 pancreaticoduodenectomies for pancreatic cancer: a single-institution experience[J]. J Gastrointest Surg, 2006,10(9):1199

相似文献/References:

[1]孙伟林 综 述,邓靖宇,梁 寒 审 校.胃癌根治术后近期并发症的防治进展[J].天津医科大学学报,2019,25(02):194.
[2]郭世伟 综述,邓靖宇 审校.胃癌根治术后乳糜漏的研究进展[J].天津医科大学学报,2020,26(05):497.

备注/Memo

备注/Memo:
文章编号 1006-8147(2018)03-0212-04
作者简介 郑凯源(1991-),男,硕士在读,研究方向:普通外科;通信作者:付蔚华,E-mail:1162030455@qq.com。
更新日期/Last Update: 2018-05-20