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头颈部微血管重建手术后非计划再入院情况分析

An analysis of unplanned readmissions after head and neck microvascular reconstructive surgery.

作者信息

Weyh A, Nocella R, Abdelmalik M, Pucci R, Quimby A, Bunnell A, Fernandes R

机构信息

Department of Oral and Maxillofacial Surgery, University of Florida Jacksonville, Jacksonville, FL, USA.

Department of Maxillofacial Surgery, Sapienza University of Rome, Rome, Italy.

出版信息

Int J Oral Maxillofac Surg. 2020 Dec;49(12):1559-1565. doi: 10.1016/j.ijom.2020.04.017. Epub 2020 May 29.

Abstract

The 30-day readmission rate is a highly scrutinized metric of quality surgical care, because readmission is costly and perceived to be avoidable with planning and patient education. Head and neck surgery patients generally have multiple risk factors for readmission, as readmitted patients are generally older, with more co-morbidities, lower socio-economic status, and a history of multiple emergency department visits and readmissions. A retrospective cohort study was implemented to determine the incidence and etiology of 30-day readmission after microvascular head and neck reconstructive surgery, focusing on social risk factors. Data were analyzed by χ test, analysis of variance, t-test, and logistic regression, with statistical significance set at P<0.05. Of 209 patients included in this study, 35 (16.7%) had a 30-day readmission. Increased needs at discharge were associated with increased readmission, while other social risk factors were less significant for a readmission in this study.

摘要

30天再入院率是衡量外科手术护理质量的一个受到高度审视的指标,因为再入院成本高昂,而且人们认为通过规划和患者教育是可以避免的。头颈外科手术患者通常有多种再入院风险因素,因为再次入院的患者一般年龄较大,合并症更多,社会经济地位较低,并且有多次急诊科就诊和再入院史。开展了一项回顾性队列研究,以确定微血管头颈重建手术后30天再入院的发生率和病因,重点关注社会风险因素。数据采用χ检验、方差分析、t检验和逻辑回归进行分析,统计学显著性设定为P<0.05。本研究纳入的209例患者中,35例(16.7%)有30天再入院情况。出院时需求增加与再入院增加相关,而在本研究中其他社会风险因素对再入院的影响较小。

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