Propst Katie, O'Sullivan David M, Tulikangas Paul K
Female Pelvic Medicine and Reconstructive Surgery, Department of Women's Health, Hartford Hospital, 85 Seymour Street, Suite 525, Hartford, CT, 06106, USA.
Research Administration, Hartford Hospital, Hartford, CT, USA.
Int Urogynecol J. 2017 Oct;28(10):1463-1467. doi: 10.1007/s00192-017-3293-8. Epub 2017 Feb 24.
Hospital readmission is increasingly used as a measure of quality care. Our objective was to evaluate the rate of readmission and associated factors in women undergoing suburethral sling placement in the USA.
This is a cohort study of suburethral sling procedures performed in the USA from 2012 to 2014 using the American College of Surgeons' National Surgical Quality Improvement Program database. The database was queried for suburethral sling procedures. Records were excluded if concomitant surgery had been performed. Patient and surgical characteristics were evaluated for association with readmission using Chi-squared test for categorical variables and Student's t test for continuous variables. All results yielding p < 0.05 were deemed statistically significant.
A total of 7,117 suburethral sling procedures were identified. There were 83 (1.16%) hospital readmissions. Those who were readmitted tended to be older (p = 0.011), non-Hispanic (p = 0.04), smokers (p < 0.001), and have an American Society of Anesthesiologists Physical Status Classification System score of 3 or 4 (p = 0.001). A history of bleeding disorder (p < 0.001), congestive heart failure (p < 0.001), or chronic obstructive pulmonary disease (p < 0.001) was associated with readmission. Fifty-four (0.75%) patients underwent reoperation within 30 days of suburethral sling placement. The most common reoperation procedure was sling excision (20 patients). The most common complication was urinary tract infection, which occurred in 189 patients (2.7%).
Suburethral sling placement is a safe procedure with a low rate of readmissions, reoperations, and complications. Consistent with other types of surgery, infection is the most common post-operative complication.
医院再入院率越来越多地被用作衡量医疗质量的指标。我们的目标是评估美国接受尿道下吊带置入术的女性患者的再入院率及相关因素。
这是一项队列研究，利用美国外科医师学会国家外科质量改进计划数据库，对2012年至2014年在美国进行的尿道下吊带手术进行分析。在数据库中查询尿道下吊带手术记录。若患者同时接受了其他手术，则排除其记录。使用卡方检验分析分类变量、学生t检验分析连续变量，评估患者和手术特征与再入院之间的关联。所有p值小于0.05的结果均被视为具有统计学意义。
共识别出7117例尿道下吊带手术。其中83例（1.16%）出现医院再入院情况。再入院患者往往年龄较大（p = 0.011）、非西班牙裔（p = 0.04）、吸烟者（p < 0.001），且美国麻醉医师协会身体状况分类系统评分为3或4（p = 0.001）。出血性疾病史（p < 0.001）、充血性心力衰竭（p < 0.001）或慢性阻塞性肺疾病史（p < 0.001）与再入院相关。54例（0.75%）患者在尿道下吊带置入术后30天内接受了再次手术。最常见的再次手术是吊带切除术（20例患者）。最常见的并发症是尿路感染，189例患者（2.7%）出现该并发症。
尿道下吊带置入术是一种安全的手术，再入院率、再次手术率和并发症发生率较低。与其他类型的手术一致，感染是最常见的术后并发症。
