Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Am J Surg. 2022 Jun;223(6):1047-1052. doi: 10.1016/j.amjsurg.2021.10.024. Epub 2021 Oct 16.
Health literacy is a determinant of health. Few studies characterize its association with surgical outcomes.
Retrospective cohort study of patients undergoing elective colorectal surgery 2015-2020. Health literacy assessed using Brief Health Literacy Screening Tool. Outcomes were postoperative complications, LOS, readmissions, mortality.
Of 552 patients, 46 (8.3%) had limited health literacy, 506 (91.7%) non-limited. Median age 57.7 years, 305 (55.1%) patients were female, 148 (26.8%) were Black. Limited patients had higher rates of overall complications (43.5% vs. 24.3%, p = 0.004), especially surgical site infections (21.7% vs. 11.3%, p = 0.04). Limited patients had longer LOS (5 vs 3.5 days, p = 0.006). Readmissions and mortality did not differ. On multivariable analysis, limited health literacy was independently associated with increased risk of complications (OR 2.03, p = 0.046), not LOS (IRR 1.05, p = 0.67).
Limited health literacy is associated with increased likelihood of complications after colorectal surgery. Opportunities exist for health literate surgical care to improve outcomes for limited health literacy patients.
健康素养是健康的决定因素。很少有研究描述其与手术结果的关系。
对 2015 年至 2020 年接受择期结直肠手术的患者进行回顾性队列研究。使用简短健康素养筛查工具评估健康素养。结果是术后并发症、住院时间、再入院、死亡率。
在 552 名患者中，46 名（8.3%）有有限的健康素养，506 名（91.7%）无限制。中位年龄为 57.7 岁，305 名（55.1%）患者为女性，148 名（26.8%）为黑人。有限的患者总体并发症发生率较高（43.5%比 24.3%，p=0.004），尤其是手术部位感染（21.7%比 11.3%，p=0.04）。有限的患者住院时间较长（5 天比 3.5 天，p=0.006）。再入院和死亡率没有差异。多变量分析显示，有限的健康素养与并发症风险增加独立相关（OR 2.03，p=0.046），而与住院时间无关（IRR 1.05，p=0.67）。
有限的健康素养与结直肠手术后并发症的发生几率增加相关。有机会通过健康素养的手术护理来改善有限健康素养患者的结局。
