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评价罗特曼指数预测结直肠切除术后再入院的价值。

Evaluation of the Rothman Index in Predicting Readmission after Colorectal Resection.

机构信息

Division of Colon and Rectal Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.

Division of Biostatistics, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.

出版信息

Am J Med Qual. 2023 Nov 1;38(6):287-293. doi: 10.1097/JMQ.0000000000000149.

Abstract

The Rothman Index (RI) is a real-time health indicator score that has been used to quantify readmission risk in several fields but has never been studied in gastrointestinal surgery. In this retrospective single-institution study, the association between RI scores and readmissions after unplanned colectomy or proctectomy was evaluated in 427 inpatients. Patient demographics and perioperative measures, including last RI, lowest RI, and increasing/decreasing RI score, were collected. In the selected cohort, 12.4% of patients were readmitted within 30 days of their initial discharge. Last RI, lowest RI, decreasing RI, and increasing RI scores remained significant after controlling for covariates in separate multivariate regression analyses. The last RI score at the time of discharge was found to be the most strongly associated with 30-day readmission risk following colorectal resection. These findings support the RI as a potential tool in the inpatient management of postoperative patients to identify those at high risk of readmission.

摘要

罗氏指数(RI)是一种实时健康指标评分,已被用于量化多个领域的再入院风险,但从未在胃肠外科手术中进行过研究。在这项回顾性单中心研究中,评估了 427 名住院患者的 RI 评分与计划性结肠切除术或直肠切除术出院后再入院之间的关联。收集了患者的人口统计学和围手术期指标,包括最后 RI、最低 RI 和 RI 评分增加/减少。在选定的队列中,12.4%的患者在初次出院后 30 天内再次入院。在分别进行多变量回归分析控制协变量后,最后 RI、最低 RI、下降 RI 和上升 RI 评分仍然具有显著意义。发现出院时的最后 RI 评分与结直肠切除术后 30 天再入院风险最密切相关。这些发现支持 RI 作为术后患者住院管理中识别高再入院风险的潜在工具。

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