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心脏直视手术后 30 天内计划性再入院的频率和危险因素:一家三级护理中心的回顾性研究。

Frequency and Risk Factors of Unplanned 30-Day Readmission After Open Heart Surgeries: A Retrospective Study in a Tertiary Care Center.

机构信息

Department of Surgery, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.

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出版信息

Heart Surg Forum. 2022 Aug 21;25(4):E608-E615. doi: 10.1532/hsf.4875.

Abstract

BACKGROUND

Unplanned 30-day readmission post-cardiac surgery imposes higher risks for complications, increased costs, and unfavorable events for the care provider and patient. This study was to determine the unplanned readmission rate, determinants, and most common events within 30 days post-cardiac surgery. Recommendations to prevent or minimize these complications are included.

METHODS

Setting and design - a retrospective record review was conducted among all adult patients, who underwent open heart surgery between 2010 and 2020 at King Abdulaziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia. Using Google Forms, we manually collected data from hospital records.

STATISTICAL ANALYSIS USED

binomial logistic regression model (using the backward stepwise method). Regression outcomes were expressed as odds ratios (ORs) and 95% CIs. A P-value of < 0.05 indicated statistical significance.

RESULTS

Among 400 patients who underwent cardiac surgery, 343 patients were included in the study, including 53 unplanned readmissions, which was a rate of 16.3% (95% CI, 12.8 to 20.6%). The most frequently reported reasons for readmission were sternal wound infections (7.3%), pleural effusion (2.0%), and heart failure (1.7%). Female gender, high postoperative LDH and urea were the most important risk factors.

CONCLUSION

Discharge planning, patient education, and cardiac surgery nurse home visit constitute the most important factors to minimize 30 days of unplanned readmission.

摘要

背景

心脏手术后 30 天内的非计划性再入院会增加并发症风险、增加成本,并对医疗服务提供者和患者产生不利影响。本研究旨在确定心脏手术后 30 天内的非计划性再入院率、决定因素和最常见事件,并提出预防或最小化这些并发症的建议。

方法

研究设计与背景-对 2010 年至 2020 年期间在沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学医院(KAUH)接受心脏直视手术的所有成年患者进行回顾性病历回顾。我们使用 Google 表单从医院记录中手动收集数据。

统计学分析方法

使用二项逻辑回归模型(使用向后逐步法)。回归结果表示为比值比(ORs)和 95%置信区间(CI)。P 值<0.05 表示具有统计学意义。

结果

在 400 例接受心脏手术的患者中,有 343 例患者纳入研究,其中 53 例为非计划性再入院,再入院率为 16.3%(95%CI,12.8 至 20.6%)。再入院最常见的原因是胸骨伤口感染(7.3%)、胸腔积液(2.0%)和心力衰竭(1.7%)。女性、术后高乳酸脱氢酶和尿素是最重要的危险因素。

结论

出院计划、患者教育和心脏外科护士家访是减少 30 天非计划性再入院的最重要因素。

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