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了解单一儿科普通外科科室接受手术的儿童的非计划性再入院情况。

Understanding unplanned readmissions for children undergoing surgery in a single pediatric general surgical department.

机构信息

Department of Pediatric General Surgery, Children's Hospital, Chongqing Medical University, Chongqing, People's Republic of China.

Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital, Chongqing Medical University, 136, 2nd Rd. Chongqing, Zhongshan, 400014, People's Republic of China.

出版信息

BMC Pediatr. 2019 Sep 26;19(1):340. doi: 10.1186/s12887-019-1672-7.

Abstract

BACKGROUND

The aim of the current research was to investigate the unplanned readmission rates and identify the risk factors of unplanned readmissions in pediatric general surgical specialties.

METHODS

A retrospective review of unplanned readmissions following initial surgery from July 1, 2010, to June 30, 2017, in the general surgical specialties at an academic tertiary care hospital was performed. The main outcome of interest was unplanned readmission rates, the common causes for readmission. The risk factors involved in the unplanned readmissions were further investigated using univariate and multivariate analyses.

RESULTS

Of the 3263 patients who underwent surgery and discharge, 176 (9%) were unplanned readmissions. The most frequent surgical operation related to readmission was appendectomy, and the common readmission causes were associated with treatment of gastrointestinal complaints/complications. Multivariable analysis demonstrated that emergency surgery (p = 0.016, odds ratio [OR] = 2.73; 95% CI = 1.35-6.19), major complications (p = 0.042, OR = 2.43; 95% CI = 1.12-4.71) and the initial hospital length of stay (p = 0.036, OR = 3.46; 95% CI = 1.67-7.53) were independent risk factors for readmission.

CONCLUSIONS

This study identified potential risks for readmission, which should be targeted for interventions to improve quality and resource allocation.

摘要

背景

本研究旨在调查小儿普通外科专业的非计划性再入院率,并确定非计划性再入院的风险因素。

方法

对 2010 年 7 月 1 日至 2017 年 6 月 30 日在一家学术性三级保健医院普通外科专业进行初始手术后的非计划性再入院情况进行回顾性分析。主要观察指标为非计划性再入院率及再入院的常见原因。使用单因素和多因素分析进一步研究非计划性再入院的相关风险因素。

结果

在 3263 例接受手术和出院的患者中,有 176 例(9%)发生了非计划性再入院。与再入院最相关的手术操作是阑尾切除术,常见的再入院原因与胃肠道症状/并发症的治疗有关。多变量分析表明,急诊手术(p=0.016,比值比[OR] = 2.73;95%置信区间[CI] = 1.35-6.19)、严重并发症(p=0.042,OR = 2.43;95%CI = 1.12-4.71)和初始住院时间(p=0.036,OR = 3.46;95%CI = 1.67-7.53)是非计划性再入院的独立危险因素。

结论

本研究确定了再入院的潜在风险因素,应针对这些因素进行干预,以提高质量和资源配置。

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