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接受外周动脉疾病治疗患者30天内再入院的危险因素

Risk Factors for 30-Day Hospital Readmission in Patients Undergoing Treatment for Peripheral Artery Disease.

作者信息

Han Sukgu M, Wu Bian, Eichler Charles M, Reilly Linda M, Vartanian Shant M, Conte Michael S, Hiramoto Jade

机构信息

Division of Vascular and Endovascular Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA, USA

Division of Vascular and Endovascular Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA, USA.

出版信息

Vasc Endovascular Surg. 2015 Apr-May;49(3-4):69-74. doi: 10.1177/1538574415593498. Epub 2015 Jul 5.

Abstract

Early hospital readmission among vascular surgery patients is a focus of Medicare's new reimbursement structure. We aim to identify factors associated with 30-day readmission after lower extremity interventions to treat peripheral artery disease (PAD). Retrospective analysis of 174 consecutive patients discharged from the vascular surgery service between January 1, 2011, and July 31, 2012, after procedures for lower extremity PAD was performed. Of 174 patients, 37 were readmitted within 30 days of discharge. There were no significant differences in baseline characteristics between the readmitted and the nonreadmitted groups. In a multivariate logistic regression model, urgent operation and advanced chronic kidney disease (CKD) were associated with increased risk of 30-day readmission. The most common reasons for readmission were infection of the surgical site or index limb (18 of 37), followed by unresolved limb symptoms (13 of 37). The 30-day readmission is frequent after lower extremity interventions to treat PAD. Urgent operative intervention and advanced CKD appear to be risk factors for early hospital readmission.

摘要

血管外科患者的早期医院再入院是医疗保险新报销结构的关注重点。我们旨在确定下肢干预治疗外周动脉疾病(PAD)后30天再入院的相关因素。对2011年1月1日至2012年7月31日期间接受下肢PAD手术并从血管外科出院的174例连续患者进行回顾性分析。174例患者中,37例在出院后30天内再次入院。再入院组和未再入院组的基线特征无显著差异。在多因素逻辑回归模型中,急诊手术和晚期慢性肾脏病(CKD)与30天再入院风险增加相关。再入院的最常见原因是手术部位或指数肢体感染(37例中的18例),其次是肢体症状未缓解(37例中的13例)。下肢干预治疗PAD后30天再入院很常见。急诊手术干预和晚期CKD似乎是早期医院再入院的危险因素。

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