Chen Liang-Yi, Chang Yu, Wong Chia-En, Chi Kuan-Yu, Lee Jung-Shun, Huang Chi-Chen, Lee Po-Hsuan
Section of Neurosurgery, Department of Surgery, College of Medicine, National Cheng Kung University, 63461National Cheng Kung University Hospital, Tainan, Taiwan.
Department of Education, Center for Evidence-Based Medicine, 63474Taipei Medical University Hospital, Taipei, Taiwan.
Global Spine J. 2023 Mar;13(2):563-574. doi: 10.1177/21925682221116823. Epub 2022 Aug 30.
Systematic review.
Surgical procedures for lumbar degenerative diseases (LDD), which have emerged in the 21-century, are commonly practiced worldwide. Regarding financial burdens and health costs, readmissions within 30days following surgery are inconvenient. We performed a systematic review to integrate real-world evidence and report the current risk factors associated with 30-day readmission following surgery for LDD.
The Cochrane Library, Embase, and Medline electronic databases were searched from inception to April 2022 to identify relevant studies reporting risk factors for 30-day readmission following surgery for LDD.
Thirty-six studies were included in the review. Potential risk factors were identified in the included studies that reported multivariate analysis results, including age, race, obesity, higher American Society of Anesthesiologists score, anemia, bleeding disorder, chronic pulmonary disease, heart failure, dependent status, depression, diabetes, frailty, malnutrition, chronic steroid use, surgeries with anterior approach, multilevel spinal surgeries, perioperative transfusion, presence of postoperative complications, prolonged operative time, and prolonged length of stay.
There are several potential perioperative risk factors associated with unplanned readmission following surgery for LDD. Preoperatively identifying patients that are at increased risk of readmission is critical for achieving the best possible outcomes.
系统评价。
21世纪出现的腰椎退行性疾病（LDD）手术在全球范围内广泛应用。考虑到经济负担和医疗成本，术后30天内再次入院很不方便。我们进行了一项系统评价，以整合真实世界证据，并报告LDD手术后30天再次入院的当前相关危险因素。
检索Cochrane图书馆、Embase和Medline电子数据库，检索时间从建库至2022年4月，以确定报告LDD手术后30天再次入院危险因素的相关研究。
该评价纳入了36项研究。在报告多变量分析结果的纳入研究中确定了潜在危险因素，包括年龄、种族、肥胖、美国麻醉医师协会评分较高、贫血、出血性疾病、慢性肺病、心力衰竭、依赖状态、抑郁、糖尿病、虚弱、营养不良、长期使用类固醇、前路手术、多节段脊柱手术、围手术期输血、术后并发症的存在、手术时间延长和住院时间延长。
LDD手术后计划外再次入院存在若干潜在的围手术期危险因素。术前识别再次入院风险增加的患者对于实现最佳治疗效果至关重要。
