Alsulaimani Abeer I, Alzahrani Khalid M, Al Towairgi Khalid M, Alkhaldi Layla M, Alrumaym Amani H, Alhossaini Zouhor A, Algethami Rami F
Medicine, Taif University, Taif, SAU.
General Surgery, Taif University, Taif, SAU.
Cureus. 2022 Jul 19;14(7):e27014. doi: 10.7759/cureus.27014. eCollection 2022 Jul.
The admission of patients on weekends in multiple health centers has been associated with poorer outcomes relative to care provided during regular weekday hours. This study aimed to assess and compare the health outcomes of patients discharged on weekends and weekdays after undergoing surgery in a tertiary hospital in Taif, Saudi Arabia.
The data of patients were collected from hospital records in a retrospective manner, and the outcomes were assessed after discharge. Patients discharged on Friday and Saturday were considered weekend discharges, and those discharged on other days were considered weekday discharges. Data related to readmission and emergency department (ED) visits included the primary diagnosis, number of days post-primary discharge, length of stay, chief complaint, and the number of ED visits. A logistic regression model was done to assess the predictive factor for 30-readmission after surgery. Results: The frequency of discharge over the weekend was 9.1%. About 6.5% and 7.3% were found to have 30-day readmission and 30-day ED visits, respectively. A statistically significant association was not observed between weekend discharge and the development of postoperative complications (p>0.05). A multinomial logistic regression showed that patients who had emergency admission, postoperative complications, and the presence of cancer were found to be independently associated with 30-day readmission after discharge (P<0.05).
Proactive strategies to reduce costly readmissions after surgery can be designed once the high-risk patient subset is identified.
与在工作日常规时间提供的护理相比,多个医疗中心在周末收治患者的预后较差。本研究旨在评估和比较沙特阿拉伯塔伊夫一家三级医院手术后在周末和工作日出院的患者的健康结局。
以回顾性方式从医院记录中收集患者数据,并在出院后评估结局。周五和周六出院的患者被视为周末出院患者,其他日期出院的患者被视为工作日出院患者。与再入院和急诊科就诊相关的数据包括主要诊断、首次出院后天数、住院时间、主要诉求以及急诊科就诊次数。进行逻辑回归模型以评估术后30天再入院的预测因素。结果:周末出院频率为9.1%。分别有6.5%和7.3%的患者出现30天再入院和30天急诊科就诊。未观察到周末出院与术后并发症发生之间存在统计学显著关联(p>0.05)。多项逻辑回归显示,急诊入院、术后并发症和患有癌症的患者在出院后30天再入院方面存在独立关联(P<0.05)。
一旦确定高风险患者亚组,就可以设计积极策略以减少术后代价高昂的再入院情况。