胃癌根治术后出院30天内非计划再入院危险因素分析

Risk factors of unplanned readnission after radical gastrectomy for gastric cancer

目的研究胃癌根治术后出院30d内非计划再次入院的发生率及危险因素。方法前瞻性收集2013年10月至2015年12月行择期胃癌根治术755例患者,再入院的定义为出院后30d内非计划再次入院。随访直到出院后30d,收集资料,确定再入院的发生率和危险因素。采用统计学单因素及多因素分析确定再入院的危险因素。结果 755例患者出院后30d内非计划再入院发生率为7.2%。通过单因素及多因素logistic回归分析,NRS2002评分≥3分(P=0.02)以及首次住院曾经发生术后并发症(P=0.006)是出院后30d内非计划再入院的独立危险因素。结论首次住院曾发生术后并发症及存在营养不良风险是再入院的独立危险因素。术前加强营养支持及努力减少术后并发症可降低再入院风险。

Objective To determine the risk factors of readmission within 30 days of discharge after gastrectomy for patients with gastric cancer. Methods All patients undergoing elective gastrectomy for gastric cancer from October 2013 to December 2015 at our institution were followed up until 30 days after discharge. Readmission was defined as admission in hospital within 30 days of discharge. The risk factors of unplanned readmission within 30 days were identified with univariate and multivariate regression analyses. Results A total of 755 patients undergoing gastrectomy for gastric cancer were included in our analysis without drop off in the follow-up. The 30-day unplanned readmission rate after radical gastrectomy for gastric cancer was 7.2%. The univariate and multivariate logistic regression analyses showed that preoperative nutritional risk screening 2002 （NRS2002） score ≥3 （P=0.02） and a history of a major postoperative complication during hospitalization （P=0.006） were independent risk factors for 30-day readmission. Conclusion Readmission within 30 days of discharge after radical gastrecto- my for gastric cancer is common. Patients with nutritional risk preoperatively or a history of a major postoperative complication are at high risk for 30-day readmission.