Chiesa-Estomba Carlos Miguel, Sistiaga-Suárez Jon Alexander, González-García José Ángel, Sarasola Ekhiñe Larruscain, Vilanova Ariadna Valldeperes, Altuna Xabier
Department of Otorhinolaryngology - Head & Neck Surgery, Hospital Universitario Donostia, San Sebastian - Donosti, Guipuzkoa - Basque, Spain.
Int Arch Otorhinolaryngol. 2021 Aug 4;26(1):e103-e110. doi: 10.1055/s-0041-1730340. eCollection 2022 Jan.
Head and neck surgery remains a complex field; the patients can suffer important functional or life-threating complications after treatment that need unplanned readmissions, increasing the cost related to the treatment. To evaluate the incidence risk factors and causes associated with 30-day unplanned hospital readmission and visit to the emergency room (ER) after surgery for head and neck cancer. Prospective, longitudinal, nonrandomized study. A total of 834 patients were included, 726 in the major surgery group and 108 in the minor surgery group. The 30-day readmission rate for all causes was of 7,9% for the patients treated by a major surgery and of 0% for the patients treated in the outpatient clinic for minor procedures, to a total readmission rate of 6,8%. The rate of visit to the emergency room for all causes in the first 30 days was of 14% for the patients treated by a major surgery and of 2,7% for the patients treated in the outpatient clinic. Major surgery, the American Society of Anesthesiologists (ASA) status and type of wound are conditions related to unplanned readmission or visit to the ER in the first 30 day after discharge. The most commonly associated causes are infections or wound complications. An evidence-based risk stratification of the patients can be important to improve decision-making and resource utilization. An educational strategy can provide possible ways to improve the rate of readmission and reduce the amount of money expended by healthcare systems.
头颈外科仍然是一个复杂的领域;患者在治疗后可能会出现严重的功能或危及生命的并发症,需要非计划再次入院,这增加了治疗相关的费用。
评估头颈癌手术后30天非计划住院再入院及急诊就诊的发生率、危险因素及相关原因。
前瞻性、纵向、非随机研究。
共纳入834例患者,其中大手术组726例,小手术组108例。大手术治疗的患者所有原因的30天再入院率为7.9%,门诊小手术治疗的患者为0%,总再入院率为6.8%。大手术治疗的患者前30天所有原因的急诊就诊率为14%,门诊治疗的患者为2.7%。
大手术、美国麻醉医师协会(ASA)分级及伤口类型是出院后30天内非计划再入院或急诊就诊的相关因素。最常见的相关原因是感染或伤口并发症。基于证据的患者风险分层对于改善决策和资源利用可能很重要。一种教育策略可以提供可能的方法来提高再入院率并减少医疗系统的费用支出。