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头颈部手术后60天内非计划重返医院的发生率及原因

Rate and Causes of Unplanned Hospital Returns within 60 Days following Head and Neck Surgery.

作者信息

Merdad Mazin, Alqutub Abdulsalam, Mogharbel Ahmed, Farid Abdullah, Bayazed Abdullah, Alghamdi Abdulaziz, Albogami Yazeed, Alshehri Rayan, Alnefaie Majed N, Alamoudi Hanin A

机构信息

Department of Otolaryngology, Head and Neck Surgery, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.

Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.

出版信息

Int Arch Otorhinolaryngol. 2024 Feb 16;28(3):e481-e486. doi: 10.1055/s-0044-1779433. eCollection 2024 Jul.

Abstract

Unplanned hospital returns are frequent and may be preventable.  To comprehend the reasons for unplanned hospital readmission and return to the Outpatient Department (OPD) and Emergency Department (ED) within 60 days after discharge following head and neck surgery (HNS) at a tertiary care center in Saudi Arabia.  In the present retrospective study, the medical records of all patients who underwent HNS for benign and malignant conditions between January 2015 and June 2022 were reviewed in terms of demographic data, comorbidities, and reasons for hospital return.  Out of 1,030 cases, 119 (11.55%) returned to the hospital within 60 days after discharge, 19 of which (1.84%) were readmitted. In total, 90 (8.74%) patients returned to the OPD, and 29 (2.82%), to the ED. The common reasons for readmission included infections (26.32%) and neurological symptoms (21.05%). For OPD visits, the common causes were hematoma (20%) and neurological symptoms (14.44%). For ED returns, the frequent causes were neurological symptoms (20.69%) and equipment issues (17.24%). Compared with nonreadmitted patients, readmitted patients had a higher preoperative baseline health burden when examined using the American Society of Anesthesiologists (ASA) score (  = 0.004) and the Cumulative Illness Rating Scale (CIRS;  = 0.002).  The 60-day rates of unplanned hospital return to the OPD and ED were of 8.74% and 2.82% respectively, and 1.84% of the patients were readmitted. Hematoma, infections, and neurological symptoms were common causes. Addressing the common reasons may be beneficial to decrease postoperative hospital visits.

摘要

非计划内的医院复诊很常见,且可能是可预防的。为了解沙特阿拉伯一家三级医疗中心头颈外科手术(HNS)出院后60天内非计划内再次入院以及返回门诊部(OPD)和急诊科(ED)的原因。在本回顾性研究中,对2015年1月至2022年6月期间因良性和恶性疾病接受HNS手术的所有患者的病历进行了人口统计学数据、合并症及医院复诊原因方面的审查。在1030例病例中,119例(11.55%)在出院后60天内返回医院,其中19例(1.84%)再次入院。共有90例(8.74%)患者返回OPD,29例(2.82%)返回ED。再次入院的常见原因包括感染(26.32%)和神经症状(21.05%)。对于OPD就诊,常见原因是血肿(20%)和神经症状(14.44%)。对于ED返回,常见原因是神经症状(20.69%)和设备问题(17.24%)。与未再次入院的患者相比,使用美国麻醉医师协会(ASA)评分(P = 0.004)和累积疾病评定量表(CIRS;P = 0.002)检查时,再次入院的患者术前基线健康负担更高。非计划内医院返回OPD和ED的60天发生率分别为8.74%和2.82%,1.84%的患者再次入院。血肿、感染和神经症状是常见原因。解决这些常见原因可能有助于减少术后医院就诊。

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