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肺叶切除术后再入院的危险因素:一项高质量的合作研究
Nathan M Mollberg1, Chang He2, Melissa J Clark2
1Department of Cardiothoracic Surgery, Bronson Methodist Hospital, Kalamazoo, Michigan.
The Annals of thoracic surgery
|November 22, 2024
概括
手术后的并发症增加了肺叶切除术后再入院的风险. 在出院后7天内进行早期随访可以降低肺癌患者的再入院率.
科学领域:
- 胸部外科手术 胸部外科手术
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 之前的研究将术后并发症与带切除术后的再入院联系起来.
- 这些研究往往没有考虑到并发症的时间或机构因素.
- 这项研究旨在分析带切除术后的再接收率和相关因素,考虑到这些局限性.
研究的目的:
- 为了检查肺癌的叶叶切除术后的再入院率.
- 为了确定与带切除术后再接收相关的关键因素.
- 调查并发症时间和机构对再接收的影响.
主要方法:
- 利用全州范围的18岁以上患者的数据库,为肺癌进行分叶切除 (2015-2019).
- 被排除在外的患者有住院死亡率,缺少出院/再接收数据或特定的出院地点.
- 使用物流混合模型分析,将医院作为随机拦截,以考虑机构效应和并发症时间.
主要成果:
- 总体而言,再接收率为6.9% (184/2686).
- 空气泄漏≥5天是最常见的并发症 (17.4%).
- 出院前的并发症和较高的祖布罗德分数预测了再入院的增加;更长的停留时间,更高的机构体积和早期随访 (≤7天) 预测了再入院的减少.
结论:
- 手术后的并发症显著增加了脑膜切除术后再入院的风险.
- 退院后7天内进行后续检查与重新接收风险降低有关.
- 减少再接收的战略应针对减少并发症,优化复杂病例的出院时间,及时跟进.
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