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创伤性脊髓损伤后的30天和90天再入院率:一项系统评价和荟萃分析。

30- and 90-Day Readmission Rates Following Traumatic Spinal Cord Injury: A Systematic Review and Meta-Analyses.

作者信息

Hesari Marjan, Alizadeh Seyed Danial, Malekzadeh Hamid, Tabrizi Reza, Jalalifar Mohammad-Rasoul, Shahmohammadi Alireza, Eskandari Zahra, Ghodsi Zahra, Harrop James, Rahimi-Movaghar Vafa

机构信息

Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Noncommunicable Diseases Research Center, Fasa University of Medical Science, Fasa, Iran.

出版信息

Global Spine J. 2025 May;15(4):2480-2489. doi: 10.1177/21925682241306358. Epub 2024 Dec 4.

Abstract

Study DesignSystematic Review and Meta-Analyses.ObjectiveTo assess the 30- and 90-day readmission rates after a traumatic spinal cord injury (SCI).MethodsA systematic search of MEDLINE and Embase was performed. The period was from inception to June 2022, with no language restrictions. All studies investigating the 30- and/or 90-day readmission rate following traumatic SCI were included. A random-effects model to combine effect sizes in our meta-analysis was applied.ResultsSeven out of 2959 reports met eligibility. The mean age of the patients was 50.2 ± 19.9, with a male-to-female ratio of 2.4:1. The most common traumatic SCI was cervical injury (55.3%). The meta-analysis model revealed a 30-day readmission rate of 14.2% after traumatic SCI, with heterogeneity in the studies. The 90-day readmission rate was 35.7%, with homogeneity in the studies. The meta-regression analysis found significant positive associations between cervical and thoracolumbar injuries and patient age and the 30-day readmission rate, while male sex demonstrated a negative association with the 30-day readmission rate. The 30-day readmission rate following index admission was 13.1% and the 30-day readmission rate after rehabilitation facilities was 15.8%. The study found that the 30-day readmission rate in the USA was 14.0%.ConclusionsThere is no doubt that readmission is an adverse health outcome. The outcome is also complex and multifaceted, which makes it difficult to predict. Injury level is 1 of the predictors that affect readmission, making it essential to consider factors during discharge planning for high-risk people to reduce 30-day readmission rates.

摘要

研究设计

系统评价与荟萃分析。

目的

评估创伤性脊髓损伤(SCI)后30天和90天的再入院率。

方法

对MEDLINE和Embase进行系统检索。检索时间段为数据库建立至2022年6月,无语言限制。纳入所有调查创伤性SCI后30天和/或90天再入院率的研究。在荟萃分析中应用随机效应模型合并效应量。

结果

2959篇报告中有7篇符合纳入标准。患者的平均年龄为50.2±19.9岁,男女比例为2.4:1。最常见的创伤性SCI是颈椎损伤(55.3%)。荟萃分析模型显示,创伤性SCI后30天再入院率为14.2%,各研究存在异质性。90天再入院率为35.7%,各研究具有同质性。荟萃回归分析发现,颈椎和胸腰椎损伤、患者年龄与30天再入院率之间存在显著正相关,而男性与30天再入院率呈负相关。首次入院后30天再入院率为13.1%,康复机构治疗后30天再入院率为15.8%。研究发现美国的30天再入院率为14.0%。

结论

毫无疑问,再入院是一种不良健康结局。该结局也复杂且多面,难以预测。损伤程度是影响再入院的预测因素之一,因此在为高危人群制定出院计划时考虑相关因素以降低30天再入院率至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca63/12035154/65c362a78a82/10.1177_21925682241306358-fig1.jpg

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