Í Soylu Lív, Hansen Jannick Brander, Kvist Madeline, Burcharth Jakob, Kokotovic Dunja
Department of Gastrointestinal and Hepatic Diseases, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark.
Emergency Surgery Research Group Copenhagen (EMERGE Cph), Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark.
World J Surg. 2024 Aug;48(8):1863-1872. doi: 10.1002/wjs.12260. Epub 2024 Jun 19.
Health-related quality of life (HRQoL) is a multidimensional concept used to examine the impact of patient-perceived health status on quality of life. Patients' perception of illness affects outcomes in both medical and elective surgical patients; however, not much is known about how HRQoL effects outcomes in the emergency surgical setting. This study aimed to examine if patient-reported HRQoL was a predictor of unplanned readmission after emergency laparotomy.
This study included 215 patients who underwent emergency laparotomy at the Copenhagen University Hospital, Herlev, between August 1, 2021, and July 31, 2022. Patient-reported HRQoL was assessed with the EuroQol group EQ5D index (EQ5D5L descriptive system and EQ-VAS). The population was followed from 0 to 180 days after discharge, and readmissions and days alive and out of hospital were registered. A Cox proportional hazard model was used to examine HRQoL and the risk of readmission within 30 and 180 days.
Within 30 days, 28.4% of patients were readmitted; within 180 days, the number accumulated to 45.1%. Low self-evaluated HRQoL predicted 180-day readmission and was significantly associated with fewer days out of hospital within both 90 and 180 days. Low HRQoL and discharge with rehabilitation were independent risk factors for short- (30-day) and long-term (180-day) emergency readmission.
Patient-perceived quality of life is an independent predictor of 180-day readmission, and the number of days out of hospital was correlated to self-reported HRQoL.
健康相关生活质量(HRQoL)是一个多维概念,用于研究患者感知的健康状况对生活质量的影响。患者对疾病的认知会影响内科和择期手术患者的治疗结果;然而,关于HRQoL如何影响急诊手术患者的治疗结果,我们所知甚少。本研究旨在探讨患者报告的HRQoL是否是急诊剖腹术后计划外再入院的预测因素。
本研究纳入了2021年8月1日至2022年7月31日期间在哥本哈根大学医院赫勒夫分院接受急诊剖腹手术的215例患者。采用欧洲五维度健康量表(EQ5D)指数(EQ5D-5L描述系统和EQ视觉模拟量表)评估患者报告的HRQoL。对患者出院后0至180天进行随访,记录再入院情况以及存活和出院天数。采用Cox比例风险模型研究HRQoL与30天和180天内再入院风险之间的关系。
30天内,28.4%的患者再次入院;180天内,这一数字累计至45.1%。自我评估的低HRQoL预测了180天的再入院情况,并且与90天和180天内出院天数减少显著相关。低HRQoL和康复出院是短期(30天)和长期(180天)急诊再入院的独立危险因素。
患者感知的生活质量是180天再入院的独立预测因素,出院天数与自我报告的HRQoL相关。