与袋炎再入院及费用相关的危险因素。

Risk Factors Associated With Hospital Readmission and Costs for Pouchitis.

作者信息

Gonzalez Adalberto, Gupta Kapil, Rahman Asad Ur, Wadhwa Vaibhav, Shen Bo

机构信息

Department of Gastroenterology and Hepatology, Cleveland Clinic Florida, Weston, Florida, USA.

Department of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.

出版信息

Crohns Colitis 360. 2021 Mar 27;3(2):otab006. doi: 10.1093/crocol/otab006. eCollection 2021 Apr.

DOI:10.1093/crocol/otab006

PMID:36778942

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9802153/

Abstract

BACKGROUND

Pouchitis is the most common long-term complication in patients with restorative proctocolectomy and ileal pouch-anal anastomosis. This study aimed to identify readmission rates for pouchitis and risk factors associated with readmissions in an extensive national database.

METHODS

We performed a retrospective analysis using the National Readmission Database to determine if patient demographics and clinical characteristics were predictors of hospital readmission within 30 days for adult patients (age >18 years) discharged with a principal diagnosis of pouchitis (ICD-9 code-569.71) from January 2013 to December 2013. Both univariable and multivariable analyses were performed to assess factors associated with 30-day readmission.

RESULTS

A total of 1538 patients with pouchitis who were discharged alive were identified. 10.2% [95% confidence interval: 7.6, 12.7] of these were readmitted within 30 days of discharge. The average days to readmission were 18.6 ± 1.01. Multivariable analysis of risk factors associated with readmission showed older age as a protective factor for readmission [odds ratio (OR) = 0.88 (0.81, 0.96); < 0.005]. Sex and the presence of permanent ileostomy were not associated with readmission in patients with pouchitis. The length of stay during readmissions was associated with postoperative wound infection [OR = 7.7 (94.0, 11.30); < 0.001], ileus [OR = 4.5 (1.6, 7.4); < 0.002], permanent ileostomy [OR = 3.7 (1.7, 5.7); < 0.001], and long-term use of nonsteroidal anti-inflammatory drugs [OR = 3.2 (1.06, 5.3); < 0.003].

CONCLUSIONS

Readmissions in pouchitis patients are frequent. Long-term use of nonsteroidal anti-inflammatory drugs, ileus, permanent ileostomy, and postoperative wound infection is associated with increased length of stay in readmissions.

摘要

背景

袋炎是直肠结肠切除术后回肠储袋肛管吻合术患者最常见的长期并发症。本研究旨在通过一个广泛的国家数据库确定袋炎患者的再入院率以及与再入院相关的危险因素。

方法

我们使用国家再入院数据库进行了一项回顾性分析，以确定2013年1月至2013年12月期间主要诊断为袋炎（国际疾病分类第九版编码-569.71）出院的成年患者（年龄>18岁）的人口统计学和临床特征是否为30天内医院再入院的预测因素。进行了单变量和多变量分析以评估与30天再入院相关的因素。

结果

共确定了1538例袋炎患者存活出院。其中10.2%[95%置信区间：7.6，12.7]在出院后30天内再次入院。再入院的平均天数为18.6±1.01。与再入院相关的危险因素的多变量分析显示年龄较大是再入院的保护因素[比值比（OR）=0.88（0.81，0.96）；<0.005]。性别和永久性回肠造口术的存在与袋炎患者的再入院无关。再入院期间的住院时间与术后伤口感染[OR=7.7（94.0，11.30）；<0.001]、肠梗阻[OR=4.5（1.6，7.4）；<0.002]、永久性回肠造口术[OR=3.7（1.7，5.7）；<0.001]以及长期使用非甾体抗炎药[OR=3.2（1.06，5.3）；<0.003]有关。