Department of Surgery, G4, University of Amsterdam, P.O. Box 22660, 1100DD, Amsterdam, The Netherlands.
Department of Colorectal Surgery, Cardiff & Vale University Health Board, Cardiff, UK.
Tech Coloproctol. 2022 May;26(5):333-349. doi: 10.1007/s10151-022-02580-6. Epub 2022 Feb 22.
Hospital readmissions after creation of an ileostomy are common and come with a high clinical and financial burden. The aim of this review with pooled analysis was to determine the incidence of dehydration-related and all-cause readmissions after formation of an ileostomy, and the associated costs.
A systematic literature search was conducted for studies reporting on dehydration-related and overall readmission rates after formation of a loop or end ileostomy between January 1990 and April 2021. Analyses were performed using R Statistical Software Version 3.6.1.
The search yielded 71 studies (n = 82,451 patients). The pooled incidence of readmissions due to dehydration was 6% (95% CI 0.04-0.09) within 30 days, with an all-cause readmission rate of 20% (CI 95% 0.18-0.23). Duration of readmissions for dehydration ranged from 2.5 to 9 days. Average costs of dehydration-related readmission were between $2750 and $5924 per patient. Other indications for readmission within 30 days were specified in 15 studies, with a pooled incidence of 5% (95% CI 0.02-0.14) for dehydration, 4% (95% CI 0.02-0.08) for stoma outlet problems, and 4% (95% CI 0.02-0.09) for infections.
One in five patients are readmitted with a stoma-related complication within 30 days of creation of an ileostomy. Dehydration is the leading cause for these readmissions, occurring in 6% of all patients within 30 days. This comes with high health care cost for a potentially avoidable cause. Better monitoring, patient awareness and preventive measures are required.
造口术后的住院再入院是常见的，会带来较高的临床和经济负担。本综述的目的是通过荟萃分析确定造口术后因脱水和其他原因导致的再入院率，并评估相关费用。
对 1990 年 1 月至 2021 年 4 月间发表的关于回肠造口术后形成回肠或末端造口术时脱水相关和总体再入院率的研究进行系统文献检索。分析采用 R 统计软件版本 3.6.1。
搜索结果共 71 项研究（n=82451 例患者）。30 天内因脱水导致的再入院率为 6%（95%CI 0.04-0.09），全因再入院率为 20%（95%CI 0.18-0.23）。脱水相关再入院的持续时间为 2.5-9 天。脱水相关再入院的平均费用为每位患者 2750-5924 美元。其他 15 项研究报告了 30 天内再入院的其他原因，脱水的再入院发生率为 5%（95%CI 0.02-0.14），造口出口问题为 4%（95%CI 0.02-0.08），感染为 4%（95%CI 0.02-0.09）。
造口术后 30 天内，五分之一的患者因与造口相关的并发症再次入院。脱水是这些再入院的主要原因，30 天内所有患者中有 6%出现脱水。这带来了较高的医疗成本，而且是可以预防的。需要更好的监测、患者意识和预防措施。
