Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Am J Surg. 2019 Mar;217(3):413-416. doi: 10.1016/j.amjsurg.2018.09.011. Epub 2018 Sep 21.
The objective of this study was to examine risk factors and outcomes of hospital readmission following complex hepatopancreatobiliary (HPB) surgery among the elderly.
The Nationwide Readmissions Database was queried for patients ≥ 60 years who underwent HPB surgery during 2010-2015.
The incidence of 30- and 90-day readmission was similar among patients 60-74 vs. ≥75 (P > 0.05). Patients age 60-74 years with ≥2 comorbidities had an increased odds of 30-day (OR 1.13, p = 0.021) and 90-day (OR 1.13, p = 0.005) readmission. Patients ≥75 years with ≥2 comorbidities had the highest in-hospital mortality (5%) whereas patients 60-74 years with 0 or 1 comorbidity had the lowest in-hospital mortality on readmission (3%).
Following an HPB procedure, roughly 1 in 7 elderly patients were readmitted within 30 days and 1 in 4 patients within 90 days. Elderly patients with multiple comorbidities were more likely to be readmitted at non-index hospitals.
本研究旨在探讨老年患者行复杂肝胆胰（HPB）手术后发生院内再入院的风险因素和结局。
本研究通过国家再入院数据库，检索了 2010 年至 2015 年期间行 HPB 手术的年龄≥60 岁的患者。
年龄 60-74 岁与≥75 岁的患者，30 天和 90 天再入院的发生率相似（P>0.05）。年龄 60-74 岁且合并≥2 种合并症的患者，30 天（OR 1.13，p=0.021）和 90 天（OR 1.13，p=0.005）再入院的风险增加。≥75 岁且合并≥2 种合并症的患者住院死亡率最高（5%），而年龄 60-74 岁且合并 0 或 1 种合并症的患者再入院时住院死亡率最低（3%）。
行 HPB 手术后，大约 1/7 的老年患者在 30 天内再次入院，1/4 的患者在 90 天内再次入院。合并多种合并症的老年患者更有可能在非索引医院再次入院。
