老年手术患者的手术后再住院:年龄分层分析
Caroline Andrew1, Christina M Fleischer2, Pablo Martinez Camblor3
1Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
Perioperative medicine (London, England)
|June 21, 2023
概括
与十年前相比,老年手术患者的再入院率有所下降. 然而,最年长的患者 (75岁以上) 面临着最高的30天计划外再入院风险,主要是由于医疗并发症.
科学领域:
- 老年人手术是一门老年手术.
- 医疗保健服务研究 医疗服务研究
- 外科手术的结果
背景情况:
- 老年人占手术患者的很大一部分,面临着术后再住院的高风险.
- 尽管努力提高质量,但了解这个人口群体当前的再住院趋势至关重要.
研究的目的:
- 确定美国不同年龄组的手术患者中30天无计划再住院的发生率和原因.
- 将当前的再住院率与历史数据进行比较,并确定特定年龄的趋势.
主要方法:
- 美国外科医生学院国家外科质量改善计划 (ACS NSQIP) 数据集 (2015-2019) 的回顾性分析.
- 患者被分为四个年龄组:18-49岁,50-64岁,65-74岁和75岁以上.
- 使用格雷方法分析的重新住院的累积发病率和原因 (NSQIP代码,ICD-9/10).
主要成果:
- 总体而言,在2,798,486名患者中,非计划性再住院率为7.09%.
- 随着年龄的增长,再住院率增加了6.12% (18-49岁) 到9.50% (75岁以上).
- 消化系统并发症是最常见的原因;医疗原因 (循环,呼吸) 随着年龄的增长而增加.
结论:
- 与十年前相比,老年手术患者的整体再住院率有所下降.
- 75岁及以上的患者表现出最高的30天再住院率.
- 需要针对医疗并发症的干预措施,以进一步减少老年手术患者的术后再入院.
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