Department of Medical Oncology, Hacettepe University Cancer Institute, 06100, Sıhhiye, Ankara, Turkey.
Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Support Care Cancer. 2021 Jul;29(7):4159-4164. doi: 10.1007/s00520-020-05927-7. Epub 2021 Jan 6.
Unplanned readmission in the first 30 days after discharge is an important medical problem, although the data on cancer patients is limited. So we planned to evaluate the rates and causes of early readmissions and the predisposing factors.
Patients hospitalized in Hacettepe University Oncology services between August 2018 and July 2019 were included. The demographic features, tumor stages, regular drugs, last laboratory parameters before discharge, and readmissions in the first 30 days after discharge were recorded. The predisposing features were evaluated with univariate and multivariate analyses.
A total of 562 hospitalizations were included. The mean age of the patients was 58.5 ± 14.5 years. Almost 2/3 of the hospitalizations were due to symptom palliation and infections. Eighty-three percent of the patients had advanced disease, and over 60% had an ECOG score of 2 and above. In the first 30 days after discharge, 127 patients were readmitted (22.6%). Advanced stage disease, presence of polypharmacy (5 or more regular drugs), hospitalization setting (emergency department (ED) vs. outpatient clinic), and hypoalbuminemia (< 3 gr/dL) were associated with a statistically significant increase in the risk of readmission. Among these factors, advanced-stage disease (HR: 2.847, 95% CI: 1.375-5.895), hospitalization from ED (HR: 1.832, 95% CI: 1.208-2.777), and polypharmacy (HR: 1.782, 95% CI: 1.173-2.706) remained significant in multivariate analyses.
In this study, 22% of cancer patients had early readmissions. The readmission risk increased in patients with advanced disease, hospitalization from ED, and polypharmacy. The optimal post-discharge plan may reduce readmissions in all oncology patients, with priority for these patient groups.
出院后 30 天内的计划外再入院是一个重要的医疗问题，尽管癌症患者的数据有限。因此，我们计划评估早期再入院的发生率和原因，以及易患因素。
纳入 2018 年 8 月至 2019 年 7 月在哈塞特佩大学肿瘤科住院的患者。记录患者的人口统计学特征、肿瘤分期、常规药物、出院前最后一次实验室参数和出院后 30 天内的再入院情况。采用单因素和多因素分析评估易患因素。
共纳入 562 例住院患者。患者的平均年龄为 58.5 ± 14.5 岁。近 2/3 的住院是由于症状缓解和感染。83%的患者处于晚期疾病，超过 60%的患者 ECOG 评分为 2 分及以上。出院后 30 天内，有 127 名患者再次入院（22.6%）。晚期疾病、多药治疗（5 种或以上常规药物）、住院环境（急诊 vs. 门诊）和低白蛋白血症（<3g/dL）与再入院风险显著增加相关。在这些因素中，晚期疾病（HR：2.847，95%CI：1.375-5.895）、从急诊住院（HR：1.832，95%CI：1.208-2.777）和多药治疗（HR：1.782，95%CI：1.173-2.706）在多因素分析中仍有意义。
在这项研究中，22%的癌症患者有早期再入院。晚期疾病、从急诊住院和多药治疗的患者再入院风险增加。为所有肿瘤患者制定最佳的出院后计划可能会减少再入院，这些患者群体应优先考虑。
