Song Jianning, Yang Yingchi, Guan Wenxian, Jin Gang, Yang Yin, Chen Lin, Wan Yong, Zhang Zhongtao
Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China.
Beijing Key Laboratory of Cancer Invasion and Metastasis Research, Department of General Surgery, National Clinical Research Center for Digestive Diseases, 95 Yong-an Road, Xi-Cheng District, Beijing, 10050, China.
Perioper Med (Lond). 2024 Dec 18;13(1):119. doi: 10.1186/s13741-024-00474-9.
Prolonged postoperative ileus (PPOI) reportedly leads to compromised postoperative recovery and increased healthcare costs. However, the evidence for this claim was obtained from studies that included patients with both primary and secondary PPOI. How primary PPOI affects the hospital length of stay (LOS) and healthcare costs is not well documented. A multicenter cohort analysis was performed to investigate the potentially detrimental effect of primary PPOI on hospital LOS and healthcare costs.
In total, 2083 patients who underwent open abdominal surgery from 22 tertiary hospitals in China were prospectively registered in a PPOI cohort. Of these, 1863 patients without secondary PPOI were analyzed. Poisson regression for hospital LOS and log-transformed linear regression for healthcare costs were performed to identify whether primary PPOI was an independent risk factor.
The incidence of primary PPOI was 13.2% (246/1863). The median LOS was significantly longer in the PPOI than non-PPOI group (12 vs. 11 days, p < 0.001). The median healthcare cost was significantly higher in the PPOI than non-PPOI group (70,672 vs. 67,597 CNY, p = 0.016). Multivariate Poisson regression and log-transformed linear regression showed that 12% of prolonged LOS and 4.6% of healthcare costs were due to primary PPOI.
Primary PPOI is a potential source of prolonged hospital LOS and extra healthcare costs for patients undergoing open abdominal surgery. Cost-effective approaches are needed to manage and prevent primary PPOI.
据报道，术后肠梗阻持续时间延长（PPOI）会导致术后恢复受损和医疗费用增加。然而，这一说法的证据来自包括原发性和继发性PPOI患者的研究。原发性PPOI如何影响住院时间（LOS）和医疗费用尚无充分记录。进行了一项多中心队列分析，以研究原发性PPOI对住院LOS和医疗费用的潜在不利影响。
在中国22家三级医院接受开腹手术的2083例患者被前瞻性纳入PPOI队列。其中，对1863例无继发性PPOI的患者进行了分析。采用泊松回归分析住院LOS，对数转换线性回归分析医疗费用，以确定原发性PPOI是否为独立危险因素。
原发性PPOI的发生率为13.2%（246/1863）。PPOI组的中位LOS显著长于非PPOI组（12天对11天，p<0.001）。PPOI组的中位医疗费用显著高于非PPOI组（70672元对67597元，p=0.016）。多变量泊松回归和对数转换线性回归显示，12%的住院时间延长和4.6%的医疗费用是由原发性PPOI导致的。
原发性PPOI是开腹手术患者住院LOS延长和额外医疗费用的潜在来源。需要采用具有成本效益的方法来管理和预防原发性PPOI。
