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经尿道前列腺切除术 30 天内再入院的发生率和预测因素:单中心欧洲经验。

Incidence and predictors of readmission within 30 days of transurethral resection of the prostate: a single center European experience.

机构信息

IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Department of Urology, Milan, Italy.

University of Milan, Milan, Italy.

出版信息

Sci Rep. 2018 Apr 26;8(1):6575. doi: 10.1038/s41598-018-25069-5.

Abstract

Hospital readmission rates have been analyzed due to their contribution to increasing medical costs. Little is known about readmission rates after urological procedures. We aimed to assess the incidence and predictors of 30-day readmission after discharge in patients treated with transurethral resection of the prostate (TURP). Data from 160 consecutive patients who underwent TURP from January 2015 to December 2016 were analysed. Intra hospitalization characteristics included length of stay (LOS), catheterization time (CT) and complications. Comorbidities were scored with the Charlson Comorbidity Index (CCI). Mean (SD) age was 70.1 (8.1) yrs and mean prostate volume was 80 (20.1) ml. Mean LOS and CT were 4.9 (2.5) days and 3.3 (1.6) days, respectively. The overall 30-day readmission rate was 14.4%, but only 7 (4.4%) patients required hospitalization. The most frequent reasons for readmission were haematuria (6.8%), fever/urinary tract infections (4.3%) and acute urinary retention (3.1%). Multivariable logistic regression analysis revealed age, CCI and CT to be independent predictors of readmission. However, when analysed according to age at the time of surgery, a beneficial effect from longer CT was observed only for patients older than 75 years. These parameters should be taken in account at the time of discharge after TURP.

摘要

医院再入院率因其对增加医疗成本的贡献而受到分析。关于泌尿科手术后再入院率的了解甚少。我们旨在评估经尿道前列腺切除术 (TURP) 治疗后患者出院后 30 天内的再入院发生率和预测因素。分析了 2015 年 1 月至 2016 年 12 月期间连续 160 例接受 TURP 的患者的数据。住院期间的特征包括住院时间 (LOS)、导尿时间 (CT) 和并发症。合并症采用 Charlson 合并症指数 (CCI) 评分。平均年龄为 70.1(8.1)岁,平均前列腺体积为 80(20.1)ml。平均 LOS 和 CT 分别为 4.9(2.5)天和 3.3(1.6)天。总的 30 天再入院率为 14.4%,但只有 7(4.4%)名患者需要住院治疗。再入院的最常见原因是血尿 (6.8%)、发热/尿路感染 (4.3%)和急性尿潴留 (3.1%)。多变量逻辑回归分析显示年龄、CCI 和 CT 是再入院的独立预测因素。然而,根据手术时的年龄进行分析时,仅在年龄大于 75 岁的患者中观察到 CT 较长的有益效果。这些参数应在 TURP 后出院时考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ac7/5919965/4ff20e407eff/41598_2018_25069_Fig1_HTML.jpg

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