Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, ul. Woloska 137, 02-507, Warsaw, Poland.
Department of Quantitative Finance, Faculty of Economic Sciences, University of Warsaw, ul. Dluga 44/50, 00-241, Warsaw, Poland.
World J Surg. 2021 Feb;45(2):480-487. doi: 10.1007/s00268-020-05841-3. Epub 2020 Oct 26.
Identifying prognostic factors that are predictive of in-hospital mortality for patients in surgical units may help in identifying high-risk patients and developing an approach to reduce mortality. This study analyzed mortality predictors based on outcomes obtained from a national database of adult patients.
This retrospective study design collected data obtained from the National Health Fund in Poland comprised of 2,800,069 hospitalizations of adult patients in surgical wards during one calendar year. Predictors of mortality which were analyzed included: the patient's gender and age, diagnosis-related group category assigned to the hospitalization, length of the hospitalization, hospital type, admission type, and day of admission.
The overall mortality rate was 0.8%, and the highest rate was seen in trauma admissions (24.5%). There was an exponential growth in mortality with respect to the patient's age, and male gender was associated with a higher risk of death. Compared to elective admissions, the mortality was 6.9-fold and 15.69-fold greater for urgent and emergency admissions (p < 0.0001), respectively. Weekend or bank holiday admissions were associated with a higher risk of death than working day admissions. The "weekend" effect appears to begin on Friday. The highest mortality was observed in less than 1 day emergency cases and with a hospital stay longer than 61 days in any type of admission.
Age, male gender, emergency admission, and admission on the weekend or a bank holiday are factors associated with greater mortality in surgical units.
确定可预测外科病房患者住院期间死亡率的预后因素有助于识别高危患者并制定降低死亡率的方法。本研究基于从波兰国家成人患者数据库中获得的结果，分析了死亡率的预测因素。
本回顾性研究设计收集了波兰国家卫生基金的数据，该数据包括 2800069 名在外科病房住院的成年患者在一个日历年中的住院情况。分析的死亡率预测因素包括：患者的性别和年龄、分配给住院的诊断相关组类别、住院时间、医院类型、入院类型和入院日期。
总体死亡率为 0.8%，创伤入院的死亡率最高（24.5%）。死亡率随着患者年龄的增长呈指数增长，男性性别与死亡风险增加相关。与择期入院相比，紧急和紧急入院的死亡率分别高出 6.9 倍和 15.69 倍（p<0.0001）。周末或银行假日入院的死亡风险高于工作日入院。“周末”效应似乎从星期五开始。在任何类型的入院中，不到 1 天的紧急情况下和住院时间超过 61 天的情况下，死亡率最高。
年龄、男性、急诊入院以及周末或银行假日入院是与外科病房死亡率增加相关的因素。
