基于住院患者解剖部位的软组织与骨恶性肿瘤切除术后并发症及再次手术率
Postoperative Complication and Reoperation Rates Following Resection of Soft Tissue vs. Bone Malignancies Based on Anatomic Location in the Inpatient Setting.
作者信息
Ballatori Alexander M, Shahrestani Shane, Ton Andy, Chen Xiao T, Yamout Tarek, Gettleman Brandon S, Heckmann Nathanael D, Menendez Lawrence R, Christ Alexander B
机构信息
Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California, USA.
Virginia Spine Institute, Reston, Virginia, USA.
出版信息
Sarcoma. 2023 Mar 10;2023:5455719. doi: 10.1155/2023/5455719. eCollection 2023.
INTRODUCTION
Surgical excisions of upper and lower extremity malignancies are increasing annually, due in part to the rising incidence of sarcomas. The purpose of this study is to compare readmissions, reoperation rate, and complications following surgical excision of soft/connective tissue vs bone malignancies of the upper and lower extremities.
METHODS
The Nationwide Readmissions Database (NRD) was queried from 2016-2017 to conduct a retrospective analysis of 16,435 patients diagnosed with malignant neoplasms of the long bone (ULLB, = 1,433) and soft tissue (ULST, = 2,049) of the upper limb and malignant neoplasms of the long bone (LLLB, = 5,422) and soft tissue (LLST, = 7,531) of the lower limb. Patients who underwent surgical excision of their neoplasms were included. Binomial multivariate logistic regression was used to compare complications, nonelective readmission rates, and reoperation rates between the two groups at 30 and 90 days.
RESULTS
Average age of the ULST group was 61.88, with 36% female. Average age of the ULLB group was 44.97, with 41.90% female. Average age of the LLST group was 60.96, with 46.90% female. Average age of the LLLB group was 43.09, with 42.60% female. The ULST group had lower odds of readmission within 30 days (=0.263), which became significant within 90 days of surgery (=0.045). The LLST group had significantly higher odds of infection, reoperation within 30 to 90 days of the index surgery compared to the LLLB group ( < 0.0001). The LLST group had significantly lower odds of readmission within 30 (=0.04) and 90 days (=0.015) of the index surgery.
CONCLUSION
Patients in the ULST group had significantly lower odds of 90-day readmission compared to the ULLB group. There were also significantly lower odds of 30- and 90-day readmission in the LLST group compared to the LLLB group. However, the LLST group had significantly higher odds of infection and reoperation within 30 and 90 days compared to the LLLB group.
引言
上肢和下肢恶性肿瘤的手术切除量逐年增加，部分原因是肉瘤发病率的上升。本研究的目的是比较上肢和下肢软组织/结缔组织恶性肿瘤与骨恶性肿瘤手术切除后的再入院率、再次手术率和并发症。
方法
查询2016 - 2017年全国再入院数据库，对16435例患者进行回顾性分析，这些患者被诊断为上肢长骨恶性肿瘤（ULLB，= 1433例）和软组织恶性肿瘤（ULST，= 2049例），以及下肢长骨恶性肿瘤（LLLB，= 5422例）和软组织恶性肿瘤（LLST，= 7531例）。纳入接受肿瘤手术切除的患者。采用二项式多变量逻辑回归比较两组在30天和90天时的并发症、非选择性再入院率和再次手术率。
结果
ULST组的平均年龄为61.88岁，女性占36%。ULLB组的平均年龄为44.97岁，女性占41.90%。LLST组的平均年龄为60.96岁，女性占46.90%。LLLB组的平均年龄为43.09岁，女性占42.60%。ULST组在30天内再入院的几率较低（= 0.263），在手术后90天内变得显著（= 0.045）。与LLLB组相比，LLST组在初次手术的30至90天内感染、再次手术的几率显著更高（< 0.0001）。LLST组在初次手术的30天（= 0.04）和90天（= 0.015）内再入院的几率显著更低。
结论
与ULLB组相比，ULST组患者90天再入院的几率显著更低。与LLLB组相比，LLST组在30天和90天再入院的几率也显著更低。然而，与LLLB组相比，LLST组在30天和90天内感染和再次手术的几率显著更高。
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