King Maureen, Kerr Amy, Dixon Sandra, Taylor Sarah, Smith Alison, Merriman Charlotte, Mitchell Jenny, Canavan Jane, Hunter Verity
Thoracic Oncology Clinical Nurse Specialist, Royal Papworth Hospital, Cambridge.
Senior Thoracic Surgery Research Nurse, Heart of England NHS Foundation Trust, Birmingham.
Br J Nurs. 2019 Sep 26;28(17):S16-S22. doi: 10.12968/bjon.2019.28.17.S16.
Postoperative complications following curative lung cancer surgery are well recognised, but there is limited data on 30-day readmission rates. The UK Thoracic Surgery Group conducted a multicentre review over a 3-month period to assess readmission rates. Overall readmission among the 268 patients who had undergone primary lung cancer surgery was 30 (11%); 14/30 of readmissions occurred within 7 days of discharge, with 13/30 patients readmitted to a hospital that had not performed the surgery. The causes of readmission were mainly pulmonary related (16/30). Readmission was associated with being discharged with a pleural drain 11/30 (<0.01), having two or more postoperative complications 11/30 (<0.01) and a patient's readiness for discharge 9/30 (=0.001). There was a trend toward an association with smoking 13/30 (=0.18). The authors suggest that a greater focus on patients presenting with characteristics associated with readmission, and incorporating a patient's readiness for discharge, may reduce readmission, although more studies are needed.
肺癌根治性手术后的术后并发症已广为人知,但关于30天再入院率的数据有限。英国胸外科小组在3个月的时间内进行了一项多中心回顾,以评估再入院率。在268例接受原发性肺癌手术的患者中,总体再入院率为30例(11%);其中14/30的再入院发生在出院后7天内,13/30的患者被再次收治到未实施手术的医院。再入院的原因主要与肺部相关(16/30)。再入院与带胸腔引流管出院11/30(<0.01)、有两种或更多术后并发症11/30(<0.01)以及患者的出院准备情况9/30(=0.001)相关。与吸烟存在关联的趋势为13/30(=0.18)。作者建议,更多地关注具有与再入院相关特征的患者,并考虑患者的出院准备情况,可能会降低再入院率,不过还需要更多的研究。