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口腔鳞状细胞癌(OSCC)手术患者发生非计划住院再入院(UHR)的相关因素:来自一家三级癌症中心的经验

Factors Predisposing to the Unplanned Hospital Readmission (UHR) in Patients Undergoing Surgery for Oral Cavity Squamous Cell Carcinoma (OSCC): Experience from a Tertiary Cancer Centre.

作者信息

Thiagarajan Shivakumar, Sawhney Shikhar, Jain Siddhanth, Chakraborthy Adhara, Menon Nandini, Gupta Alaknanda, Chaukar Devendra

机构信息

Department of Head & Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra 400012 India.

出版信息

Indian J Surg Oncol. 2020 Sep;11(3):475-481. doi: 10.1007/s13193-020-01135-1. Epub 2020 Jun 15.

Abstract

Unplanned hospital readmissions (UHR) are known to add to patient morbidity, increase the cost of the treatment, and negatively impact the postoperative quality of life. The objective of the study was to identify the UHR rates of oral cavity squamous cell carcinoma (OSCC) patients following surgery and identify the predisposing factors for UHR. We conducted this retrospective analysis of all patients who underwent surgery for OSCC in our (single) surgical unit from January 2016 to December 2018. A total of 804 patients satisfied the eligibility criteria. Majority of the patients were males ( = 650, 80.8%). The median age of the patients was 50 years (Range: 16-89 years). The most common oral cavity subsite was buccal mucosa gingivobuccal (BM-GBS) OSCC. Forty patients (5%) required an UHR after discharge. The most common reason for readmissions was flap-related issues (11/40) and orocutaneous fistula (10/40). Other causes included wound infection (7/40), chest infection (2/40), hematoma/bleeding (3/40), and other lesser prevalent causes (7/40). Factors that significantly predisposed patients for UHR were re-exploration following the initial surgery [ < 0.001, OR 7.9 (4.09-15.59)] and BM-GBS subsite [< 0.001, OR: 2.89(1.24-6.73)]. The UHR rate in our study was 5%. Patients requiring re-exploration following the initial surgery and those with BM-GBS cancer were most likely to have the UHR.

摘要

已知非计划性医院再入院(UHR)会增加患者发病率、提高治疗成本,并对术后生活质量产生负面影响。本研究的目的是确定口腔鳞状细胞癌(OSCC)患者术后的UHR率,并确定UHR的诱发因素。我们对2016年1月至2018年12月在我们(单一)外科单元接受OSCC手术的所有患者进行了这项回顾性分析。共有804名患者符合入选标准。大多数患者为男性(n = 650,80.8%)。患者的中位年龄为50岁(范围:16 - 89岁)。最常见的口腔亚部位是颊黏膜牙龈颊部(BM - GBS)OSCC。40名患者(5%)出院后需要非计划性再入院。再入院的最常见原因是皮瓣相关问题(11/40)和口腔皮肤瘘(10/40)。其他原因包括伤口感染(7/40)、肺部感染(2/40)、血肿/出血(3/40)以及其他较少见的原因(7/40)。显著使患者易发生UHR的因素是初次手术后再次探查[<0.001,OR 7.9(4.09 - 15.59)]和BM - GBS亚部位[<0.001,OR:2.89(1.24 - 6.73)]。我们研究中的UHR率为5%。初次手术后需要再次探查的患者以及患有BM - GBS癌症的患者最有可能发生UHR。

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