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种族作为脊柱手术后医院再入院的预测因素。

Race as a predictor of postoperative hospital readmission after spine surgery.

作者信息

Martin Joel R, Wang Timothy Y, Loriaux Daniel, Desai Rupen, Kuchibhatla Maragatha, Karikari Isaac O, Bagley Carlos A, Gottfried Oren N

机构信息

Division of Neurosurgery, Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.

Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC 27710, USA.

出版信息

J Clin Neurosci. 2017 Dec;46:21-25. doi: 10.1016/j.jocn.2017.08.015. Epub 2017 Oct 12.

Abstract

Hospital readmission after surgery results in a substantial economic burden, and several recent studies have investigated the impact of race and ethnicity on hospital readmission rates, with the goal to identify hospitals and patients with high readmission risk. This single-institution, retrospective cohort study assesses the impact of race, along with other risk factors, on 30-day readmission rates following spinal surgery. This study is a single-institution retrospective cohort study with accrual from January 1, 2008, to December 31, 2010. Inclusion criteria included adult patients who underwent anterior and/or posterior spinal surgery. The primary aim of this study was to assess the impact of patient race and other risk factors for postoperative hospital readmission within 30days following spine surgery. A total of 1346 patients (654 male, 692 female) were included in the study. Overall, 159 patients (11.8%) were readmitted in the 30days following their surgery. Multivariate logistic regression found significant risk factors for 30-day readmission, including Black race (OR: 2.20, C.I. 95% (1.04, 4.64)) and total length of stay greater than 7days (OR: 4.73, C.I. 95% (1.72, 12.98)). Cervical surgery was associated with decreased odds of readmission (OR: 0.27, C.I. 95% (0.08, 0.91)). Our study demonstrates that race and length of hospital stay influence the incidence of 30-day readmission rates after spinal surgery. Studies such as ours will aid in identifying patients with postoperative readmission risk and help elucidate the underlying factors that may be contributing to disparities in readmission after surgery.

摘要

手术后再次入院会带来巨大的经济负担,最近的几项研究调查了种族和民族对医院再入院率的影响,目的是识别再入院风险高的医院和患者。这项单机构回顾性队列研究评估了种族以及其他风险因素对脊柱手术后30天再入院率的影响。本研究是一项单机构回顾性队列研究,纳入了2008年1月1日至2010年12月31日期间的病例。纳入标准包括接受过前路和/或后路脊柱手术的成年患者。本研究的主要目的是评估患者种族和其他风险因素对脊柱手术后30天内再次入院的影响。共有1346例患者(男性654例,女性692例)纳入研究。总体而言,159例患者(11.8%)在手术后30天内再次入院。多因素逻辑回归分析发现30天再入院的显著风险因素,包括黑人种族(比值比:2.20,95%置信区间(1.04,4.64))和住院总时长大于7天(比值比:4.73,95%置信区间(1.72,12.98))。颈椎手术与再入院几率降低相关(比值比:0.27,95%置信区间(0.08,0.91))。我们的研究表明,种族和住院时长会影响脊柱手术后30天再入院率的发生率。像我们这样的研究将有助于识别有术后再入院风险的患者,并有助于阐明可能导致手术后再入院差异的潜在因素。

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