Merdad Mazin, Alqutub Abdulsalam, Mogharbel Ahmed, Alghamdi Abdullah A, Alsulami Omar, Awadh Mohammed, Alsulami Ahmed S
Department of Otolaryngology-Head and Neck Surgery, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Saudi J Med Med Sci. 2024 Apr-Jun;12(2):162-168. doi: 10.4103/sjmms.sjmms_138_23. Epub 2024 Apr 5.
Identifying and targeting common preventable causes of 30-day hospital readmissions could help improve survival rates and reduce the healthcare burden.
To determine the rate and causes of unplanned hospital return/readmission to the Outpatient Department (OPD) or Emergency Department (ED) within 30 days after discharge following head and neck surgery (HNS) at a tertiary hospital in Western Saudi Arabia.
This retrospective study included all adult patients (aged ≥18 years) who had undergone HNS at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between January 2015 and December 2022 and returned to the OPD or ED within 30 days of being discharged.
Of 1041 patients who had undergone HNS, 84 (8.1%) returned to the hospital within 30 days after discharge: 63 (6.1%) to the OPD and 21 (2.0%) to the ED. A total of 9 (0.9%) patients were readmitted as inpatients, most commonly for infections (33.3%) and neurological symptoms, including weakness and seizures (22.2%). For OPD visits, common causes were wound swelling (25.4%) and neurological symptoms (17.5%). For ED returns, frequent causes were neurological symptoms (23.8%) and surgical site bleeding (19.1%). Readmission was associated with intensive care unit (ICU) admission during the primary hospital stay ( = 0.003) and higher preoperative baseline health burdens when examined using the American Society of Anesthesiology score ( = 0.022), the Cumulative Illness Rating Scale ( = 0.007), and the Charlson Comorbidity Index (CCI) ( = 0.006).
The rate of 30-day unplanned hospital return following head and neck surgery was 6.1% and 2.0% through the OPD and the ED, respectively; 0.9% were readmitted as inpatients. Common causes of return included wound swelling, infections, bleeding, and neurological symptoms.
识别并针对30天内医院再入院的常见可预防原因，有助于提高生存率并减轻医疗负担。
确定沙特阿拉伯西部一家三级医院中，头颈部手术（HNS）出院后30天内非计划返回门诊（OPD）或急诊（ED）的发生率及原因。
这项回顾性研究纳入了2015年1月至2022年12月期间在沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学医院接受HNS治疗且出院后30天内返回OPD或ED的所有成年患者（年龄≥18岁）。
在1041例接受HNS治疗的患者中，84例（8.1%）在出院后30天内返回医院：63例（6.1%）返回OPD，21例（2.0%）返回ED。共有9例（0.9%）患者再次入院，最常见的原因是感染（33.3%）和神经症状，包括虚弱和癫痫发作（22.2%）。对于OPD就诊，常见原因是伤口肿胀（25.4%）和神经症状（17.5%）。对于ED返回，常见原因是神经症状（23.8%）和手术部位出血（19.1%）。再入院与初次住院期间入住重症监护病房（ICU）有关（P = 0.003），并且使用美国麻醉医师协会评分（P = 0.022）、累积疾病评定量表（P = 0.007）和查尔森合并症指数（CCI）（P = 0.006）进行检查时，术前基线健康负担较高。
头颈部手术后30天内非计划返回医院的发生率，通过OPD和ED分别为6.1%和2.0%；0.9%的患者再次入院。返回的常见原因包括伤口肿胀、感染、出血和神经症状。
