Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
Gastric Cancer. 2019 Mar;22(2):413-420. doi: 10.1007/s10120-018-0856-4. Epub 2018 Jul 13.
Hospital readmission is gathering greater attention as a measure of health care quality. The introduction of fast-track surgery has led to shorter lengths of hospitalization without increasing the risk of postoperative complications and readmission. The collection of comprehensive readmission data is essential for the further improvement of patient care. The aim of the present study is to evaluate the risk factors for readmission within 30 days of discharge after gastrectomy.
A total of 1929 patients who underwent radical gastrectomy at Shizuoka Cancer Center were included in this study. A risk analysis with a stepwise logistic regression model was conducted to identify the risk factors for 30-day hospital readmission.
The 30-day readmission rate was 2.70%. Common causes of readmission were an intolerance of oral intake and the presence of an intra-abdominal abscess. The C reactive protein (CRP) level on postoperative day (POD) 3 was significantly higher in the readmitted group; however, the other surgical outcomes, including the incidence of postoperative complications, did not differ to a statistically significant extent. The stepwise logistic regression analysis revealed that CRP on POD3 ≥ 12 mg/dl [odds ratio (OR) 2.08, 95% confidence interval (CI) 1.09-3.95, p = 0.025], laparoscopic surgery (OR 2.25, 95% CI 1.17-4.31, p = 0.015), and TG (OR 2.23, 95% CI 1.17-4.78, p = 0.023) were found to be independent risk factors for readmission.
CRP on POD3 ≥ 12 mg/dl, laparoscopic surgery, and TG were identified as independent risk factors for readmission.
医院再入院作为衡量医疗质量的指标越来越受到关注。快速通道手术的引入导致住院时间缩短，而不会增加术后并发症和再入院的风险。收集全面的再入院数据对于进一步改善患者护理至关重要。本研究旨在评估胃切除术后 30 天内出院再入院的风险因素。
本研究共纳入在静冈癌症中心接受根治性胃切除术的 1929 例患者。采用逐步逻辑回归模型进行风险分析，以确定 30 天内住院再入院的风险因素。
30 天再入院率为 2.70%。再入院的常见原因是不能耐受口服摄入和存在腹腔脓肿。再入院组术后第 3 天 C 反应蛋白（CRP）水平明显升高；然而，其他手术结果，包括术后并发症的发生率，并没有统计学上的显著差异。逐步逻辑回归分析显示，术后第 3 天 CRP≥12mg/dl[比值比（OR）2.08，95%置信区间（CI）1.09-3.95，p=0.025]、腹腔镜手术（OR 2.25，95%CI 1.17-4.31，p=0.015）和 TG（OR 2.23，95%CI 1.17-4.78，p=0.023）是再入院的独立风险因素。
术后第 3 天 CRP≥12mg/dl、腹腔镜手术和 TG 被确定为再入院的独立风险因素。
