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基于人群的结肠癌和直肠癌手术后30天再入院情况比较:二者有何不同?

A population-based comparison of 30-day readmission after surgery for colon and rectal cancer: How are they different?

作者信息

Doumouras Aristithes G, Tsao Miriam W, Saleh Fady, Hong Dennis

机构信息

Department of Surgery, McMaster University, Hamilton, Ontario, Canada.

Division of General Surgery, St. Joseph's Healthcare, Hamilton, Ontario, Canada.

出版信息

J Surg Oncol. 2016 Sep;114(3):354-60. doi: 10.1002/jso.24334. Epub 2016 Jun 22.

Abstract

BACKGROUND

An implicit assumption in the analysis of colorectal readmission is that colon and rectal cancer patients are similar enough to analyze together. However, no studies have examined this assumption and whether substantial differences exist between colon and rectal cancer patients.

METHODS

This was a retrospective analysis of the differences in predictors, diagnoses, and costs of readmission between colon and rectal cancer cohorts for 30-day readmission. This study included all patients aged >18 who received an elective colectomy or low anterior resection for colorectal cancer from April 2008 until March 2012 in the province of Ontario.

RESULTS

Overall, 13,571 patients were identified and the readmission rates significantly differed between rectal and colon cancer patients (7.1% colon and 10.7% rectal P = 0.001). Diabetes, age, and discharge to long term care were significantly different among colon and rectal patients in the prediction of readmission. Readmission for renal and stoma causes was more prominent in the rectal cohort. The adjusted cost difference for readmission did not significantly differ between rectal and colon cancer $178 ($1,924-1,568 P = 0.84) CONCLUSION: Several important differences in predictors and diagnoses exist between the two cohorts. Conversely, the costs associated with readmission were homogenous between rectal and colon cancer patients. J. Surg. Oncol. 2016;114:354-360. © 2016 Wiley Periodicals, Inc.

摘要

背景

在结直肠癌再入院分析中一个隐含的假设是,结肠癌和直肠癌患者足够相似,可以一起进行分析。然而,尚无研究检验这一假设,也没有研究探讨结肠癌和直肠癌患者之间是否存在实质性差异。

方法

这是一项回顾性分析,比较结肠癌和直肠癌队列30天再入院的预测因素、诊断情况和再入院费用差异。本研究纳入了2008年4月至2012年3月在安大略省接受择期结肠切除术或低位前切除术治疗结直肠癌的所有年龄大于18岁的患者。

结果

总体而言,共识别出13571例患者,直肠癌和结肠癌患者的再入院率存在显著差异(结肠癌为7.1%,直肠癌为10.7%,P = 0.001)。在再入院预测方面,糖尿病、年龄以及出院后入住长期护理机构的情况在结肠癌和直肠癌患者之间存在显著差异。肾脏和造口相关原因导致的再入院在直肠癌队列中更为突出。直肠癌和结肠癌再入院的调整后费用差异不显著,为178美元(1924 - 1568美元,P = 0.84)。结论:两个队列在预测因素和诊断方面存在一些重要差异。相反,直肠癌和结肠癌患者再入院相关的费用是相同的。《外科肿瘤学杂志》2016年;114:354 - 360。© 2016威利期刊公司。

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