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全髋关节和膝关节置换术后 30 天再入院 - 初步的单机构预测模型。

Thirty-day readmission following total hip and knee arthroplasty - a preliminary single institution predictive model.

机构信息

Department of Orthopaedic surgery, Vanderbilt University Medical Center.

Department of Orthopaedic Surgery Cleveland Clinic, Adult Reconstruction Section, Cleveland Clinic, Ohio.

出版信息

J Arthroplasty. 2014 Aug;29(8):1532-8. doi: 10.1016/j.arth.2014.02.030. Epub 2014 Mar 4.

Abstract

We sought to identify demographic or care process variables associated with increased 30-day readmission within the total hip and knee arthroplasty patient population. Using this information, we generated a model to predict 30-day readmission risk following total hip and knee arthroplasty procedures. Longer index length of stay, discharge disposition to a nursing facility, blood transfusion, general anesthesia, anemia, anticoagulation status prior to index admission, and Charlson Comorbidity Index greater than 2 were identified as independent risk factors for readmission. Care process factors during the hospital stay appear to have a large predictive value for 30-day readmission. Specific comorbidities and patient demographic factors showed less significance. The predictive nomogram constructed for primary total joint readmission had a bootstrap-corrected concordance statistic of 0.76.

摘要

我们试图确定与全髋关节和膝关节置换患者人群中 30 天再入院率增加相关的人口统计学或护理过程变量。利用这些信息,我们生成了一个模型来预测全髋关节和膝关节置换手术后 30 天的再入院风险。较长的住院索引长度、出院到护理机构、输血、全身麻醉、贫血、索引入院前的抗凝状态以及 Charlson 合并症指数大于 2 被确定为再入院的独立危险因素。住院期间的护理过程因素似乎对 30 天再入院具有很大的预测价值。特定的合并症和患者人口统计学因素的意义较小。为主要全关节再入院构建的预测列线图具有经过 bootstrap 校正的一致性统计量为 0.76。

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