Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, 30 North 1900 East, 3B205, Salt Lake City, UT, 84132, USA.
Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, 30 North 1900 East, 3B205, Salt Lake City, UT, 84132, USA.
Am J Surg. 2019 Apr;217(4):658-663. doi: 10.1016/j.amjsurg.2018.12.013. Epub 2018 Dec 11.
Traditionally, a 30-day postoperative period is used to assess outcomes in surgery. However, it is not clear if this is sufficient. Our study assessed readmissions and their risk factors following the surgical repair of pressure ulcers in a 90-day postoperative period.
Patients with a pressure ulcer to the lower back, hip, and/or buttocks who underwent a pedicled or flap based wound operation were identified in the National Readmissions Database. We then analyzed risk factors for overall 0-90-day readmissions, early readmissions (0-30 days), and late-readmissions (31-90 days).
3329 patients were identified, of which 154 (4.66%) had surgical wound-related readmissions. A majority of these occurred after 30 days (53.89%). 90% of patients with a surgical-wound related readmission were readmitted within 63 days of index procedure.
The traditional 30-day outcome period is not enough to properly assess outcomes in pressure ulcer surgery such as readmission. We demonstrate that a period of at least 10 weeks and perhaps the entire global 90-day postoperative period would be more appropriate to evaluate readmissions after ulcer repair.
传统上，术后 30 天被用于评估手术结果。然而，目前尚不清楚这是否足够。我们的研究评估了在术后 90 天内压力性溃疡手术修复后的再入院情况及其危险因素。
在全国再入院数据库中确定了接受带蒂或皮瓣创面手术治疗的下背部、臀部和/或臀部压力性溃疡的患者。然后，我们分析了总 0-90 天再入院、早期再入院（0-30 天）和晚期再入院（31-90 天）的危险因素。
共确定了 3329 例患者，其中 154 例（4.66%）发生了与手术伤口相关的再入院。其中大多数发生在术后 30 天之后（53.89%）。90%的手术伤口相关再入院患者在指数手术后 63 天内再次入院。
传统的 30 天结果期不足以正确评估压力性溃疡手术的结果，例如再入院。我们表明，至少 10 周的时间，甚至整个术后 90 天的全球时间可能更适合评估溃疡修复后的再入院情况。
