Hokenstad Erik D, Glasgow Amy E, Habermann Elizabeth B, Occhino John A
From the *Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN; and †Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
Female Pelvic Med Reconstr Surg. 2017 Mar/Apr;23(2):131-135. doi: 10.1097/SPV.0000000000000379.
We aimed to determine the rates of readmission and reoperation for patients undergoing surgery for pelvic organ prolapse (POP).
The American College of Surgeons National Surgical Quality Improvement Program Participant User File was used to select all surgeries performed for POP from 2012 through 2014. The cohort was then reviewed for unplanned readmissions and unplanned reoperations within 30 days of POP surgery. Patient and procedural factors associated with readmission or reoperation were compared using χ analyses and Student t test. Multivariable logistic regression determined independent risk factors for both readmission and reoperation.
A total of 23,419 patients underwent surgery for POP. Of these, there were 435 (1.9%) readmissions and 341 (1.5%) reoperations within 30 days. Median numbers of days from index procedure to readmission or reoperation were 9 and 8 days, respectively. Those who were readmitted had higher American Society of Anesthesia (ASA) scores, longer operative times, and longer lengths of stay than those who were not readmitted (all P < 0.001). Patients who underwent unplanned reoperation also had higher ASA scores, longer operative times, and longer lengths of stay than those who did not undergo reoperation (all P < 0.01). The most common reasons for readmission were surgical site infection (SSI) (19.3%) and non-SSI (15.9%). The most common reason for reoperation was urologic (27.6%) such as cystoscopy or stent placement.
Readmission and reoperation rates are relatively low for patients undergoing surgery for POP. Infection, both SSI and non-SSI, accounted for 35.2% of readmissions. Identification of ASA score of 3 or higher, longer total operating time, and increased length of stay is associated with unplanned readmission and reoperation.
我们旨在确定接受盆腔器官脱垂（POP）手术患者的再入院率和再次手术率。
利用美国外科医师学会国家外科质量改进计划参与者用户文件，选取2012年至2014年期间所有因POP进行的手术。然后对该队列进行复查，以确定POP手术后30天内的非计划再入院和非计划再次手术情况。使用χ分析和学生t检验比较与再入院或再次手术相关的患者和手术因素。多变量逻辑回归确定再入院和再次手术的独立危险因素。
共有23419例患者接受了POP手术。其中，30天内有435例（1.9%）再入院，341例（1.5%）再次手术。从初次手术到再入院或再次手术的中位天数分别为9天和8天。与未再入院的患者相比，再入院患者的美国麻醉医师协会（ASA）评分更高、手术时间更长、住院时间更长（所有P<0.001）。与未进行再次手术的患者相比，接受非计划再次手术的患者也有更高的ASA评分、更长的手术时间和更长的住院时间（所有P<0.01）。再入院的最常见原因是手术部位感染（SSI）（19.3%）和非SSI（15.9%）。再次手术的最常见原因是泌尿外科方面的（27.6%），如膀胱镜检查或支架置入。
接受POP手术的患者再入院率和再次手术率相对较低。SSI和非SSI感染占再入院病例的35.2%。ASA评分为3或更高、总手术时间延长和住院时间增加与非计划再入院和再次手术相关。
