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骨科专科医院术后患者转往三级医院的原因分析

Analysis of the Reasons for Transferring Patients from Orthopedic Specialty Hospitals to Tertiary Hospitals After Surgery.

作者信息

Heo Juneyoung, Lee Su Chan, Kim Ji Hyun, Nam Chang Hyun, Lee Dong Nyoung, Baek Ji-Hoon

机构信息

Joint & Arthritis Research, Department of Neurosurgery, Himchan Hospital, Seoul 07999, Republic of Korea.

Joint & Arthritis Research, Department of Orthopaedic Surgery, Himchan Hospital, Seoul 07999, Republic of Korea.

出版信息

J Clin Med. 2025 Jul 12;14(14):4943. doi: 10.3390/jcm14144943.

Abstract

: This study investigated the reasons for transferring patients to tertiary hospitals due to complications arising after surgery at orthopedic specialty hospitals and the treatment results. : This retrospective cohort study was conducted on all orthopedic patients, except for the spine, at a single institution from January 2012 to May 2022. : Of 67,118 patients, 167 (0.24%) were transferred to a tertiary hospital after surgery. Patients' average age was 72.2 ± 9.2 years (range: 28-91 years), and there were 34 men and 133 women. The most common reason for transfer to a tertiary hospital was pulmonary embolism (27 patients, 16.2%), which occurred on an average 3.81 days (range: 0-23 days) after surgery, and 25 patients were transferred within 1 week after surgery. The next most common cause was acute cholecystitis (19 patients (11.4%), all of whom had undergone total knee arthroplasty), which occurred on an average 6.15 days (range: 1-14 days) after surgery. : The rate of transfer from the orthopedic hospital where this study was conducted to a tertiary hospital was very low at 0.24%. Pulmonary embolism, acute cholecystitis, and cerebral infarct were the most common reasons for transfer. In particular, acute cholecystitis was the second most common reason for transfer, and caution should be taken because elderly patients may experience only atypical clinical symptoms without abdominal pain or tenderness even the day after surgery.

摘要

本研究调查了骨科专科医院手术后因并发症而将患者转至三级医院的原因及治疗结果。本回顾性队列研究针对2012年1月至2022年5月期间某单一机构除脊柱外科外的所有骨科患者展开。在67118例患者中,167例(0.24%)术后被转至三级医院。患者平均年龄为72.2±9.2岁(范围:28 - 91岁),男性34例,女性133例。转至三级医院最常见的原因是肺栓塞(27例患者,16.2%),平均发生在术后3.81天(范围:0 - 23天),25例患者在术后1周内被转院。其次最常见的原因是急性胆囊炎(19例患者(11.4%),均接受了全膝关节置换术),平均发生在术后6.15天(范围:1 - 14天)。本研究所在的骨科医院转至三级医院的比例非常低,为0.24%。肺栓塞、急性胆囊炎和脑梗死是最常见的转院原因。特别是急性胆囊炎是第二常见的转院原因,应予以注意,因为老年患者即使在术后第二天可能也仅出现非典型临床症状,而无腹痛或压痛。

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