Lee Min Kyeong, Nalliah Romesh P, Kim Min Kyeong, Elangovan Satheesh, Allareddy Veeratrishul, Kumar-Gajendrareddy Praveen, Allareddy Veerasathpurush
Department of Developmental Biology, Harvard School of Dental Medicine, Boston, MA 02115, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Nov;112(5):581-91. doi: 10.1016/j.tripleo.2011.06.032.
We studied the association between presence of complications and hospitalization outcomes, including hospital charges, length of stay in hospital, and in-hospital mortality.
The Nationwide Inpatient Sample for 2008 was used. All hospital discharges with a primary diagnosis of oral and oropharyngeal cancers were selected. Presence of complications was determined by using ICD-9-CM codes. The association between the presence of complications and outcomes (hospital charges, length of stay, and in-hospital mortality) was examined by multivariable linear and multivariable logistic regression analyses. The effects of several patient- and hospital-related confounders were adjusted in the regression analyses.
A total of 17,632 hospitalizations were attributed to oral and oropharyngeal cancers. A total of 519 (2.9%) patients died in the hospitals. The total hospitalization charges were close to $1.08 billion. Oral and oropharyngeal cancers accounted for 117,472 hospitalization days (mean length of stay 6.6 days). The overall complication rate was 14.95%. The most frequently present complication was hemorrhagic complications. Among the different complications, septicemia was associated with the worst outcomes. Patients with septicemia were associated with the highest odds for in-hospital mortality (OR = 13.06, 95% CI = 3.81-48.50, P = .0001).
Presence of complications was associated with poor outcomes, such as high in-hospital mortality rates, excess hospitalization charges, and longer length of stay in hospital. Among the different complications, septicemia was associated with the worst outcomes.
我们研究了并发症的存在与住院结局之间的关联，包括住院费用、住院时间和院内死亡率。
使用2008年全国住院患者样本。选取所有以口腔和口咽癌为主要诊断的出院病例。通过国际疾病分类第九版临床修订本（ICD-9-CM）编码确定并发症的存在情况。通过多变量线性回归和多变量逻辑回归分析，研究并发症的存在与结局（住院费用、住院时间和院内死亡率）之间的关联。在回归分析中对几个与患者和医院相关的混杂因素的影响进行了调整。
共有17632例住院病例归因于口腔和口咽癌。共有519例（2.9%）患者在医院死亡。住院总费用接近10.8亿美元。口腔和口咽癌占117472个住院日（平均住院时间6.6天）。总体并发症发生率为14.95%。最常见的并发症是出血性并发症。在不同的并发症中，败血症与最差的结局相关。败血症患者院内死亡的几率最高（比值比=13.06，95%置信区间=3.81-48.50，P=0.0001）。
并发症的存在与不良结局相关，如高院内死亡率、高额住院费用和更长的住院时间。在不同的并发症中，败血症与最差的结局相关。
