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股骨头骨骺滑脱手术治疗后再入院的危险因素。

Risk Factors for Readmission After Surgical Treatment of Slipped Capital Femoral Epiphysis.

作者信息

Gutman Ilya M, Niemeier Thomas E, Gilbert Shawn R

出版信息

Orthopedics. 2019 Nov 1;42(6):e507-e513. doi: 10.3928/01477447-20191001-02. Epub 2019 Oct 7.

DOI:10.3928/01477447-20191001-02
PMID:31587079
Abstract

Slipped capital femoral epiphysis (SCFE) is a common, surgically treated adolescent hip condition. This study sought to evaluate postoperative complications and factors associated with hospital readmission using a nationally representative database. The 2013 Healthcare Cost and Utilization Project's Nationwide Readmissions Database was queried to analyze the incidence of acute readmission and complications for all patients with SCFE. Patients were separated based on 3 different operative approaches (open procedures, closed procedures, or both) and were compared based on choice of procedure, clinical characteristics, patient demographics, comorbidities, and complications. Univariate and multivariate techniques were used to predict readmission and complications. A total of 1082 patients with SCFE were identified; 58 (5.9%) were readmitted within 90 days of the index surgery, and 47 (73.4%) underwent a "closed" surgery, including 18 bilateral (27.4%). Increasing age and shorter primary length of stay were protective against readmission. Patients with the comorbidity of hypothyroidism were 47.4 times more likely to be readmitted. Obesity, sex, and median household income were not predictive of readmission. Patients readmitted were more likely to have undergone an index procedure of closed reduction or both an open and closed reduction procedure. This study is the first to report national SCFE readmission and complication rates and allows pediatric orthopedic surgeons to have a better understanding of associated risk factors. [Orthopedics. 2019; 42(6):e507-e513.].

摘要

股骨头骨骺滑脱(SCFE)是一种常见的、需手术治疗的青少年髋关节疾病。本研究旨在使用全国代表性数据库评估术后并发症及与再次入院相关的因素。查询了2013年医疗保健成本与利用项目的全国再入院数据库,以分析所有SCFE患者的急性再入院率和并发症发生率。根据3种不同的手术方式(开放手术、闭合手术或两者皆有)对患者进行分类,并根据手术方式的选择、临床特征、患者人口统计学资料、合并症和并发症进行比较。采用单变量和多变量技术预测再入院和并发症情况。共识别出1082例SCFE患者;58例(5.9%)在首次手术后90天内再次入院,47例(73.4%)接受了“闭合”手术,其中18例为双侧手术(27.4%)。年龄增加和首次住院时间缩短可预防再入院。患有甲状腺功能减退症合并症的患者再次入院的可能性高47.4倍。肥胖、性别和家庭收入中位数不能预测再入院情况。再次入院的患者更有可能接受了闭合复位或开放与闭合复位联合的首次手术。本研究首次报告了全国范围内的SCFE再入院率和并发症发生率,使小儿骨科医生能够更好地了解相关风险因素。[《骨科》。2019年;42(6):e507 - e513。]

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