胃癌根治术出院后30 d内非计划再入院的原因及危险因素分析

Analysis of risk factors and causes for unplanned readmission for patients with gastric cancer within 30 days after radical gastrectomy

目的:探讨胃癌根治术患者出院后30 d内非计划再入院的危险因素及原因。方法:回顾性收集497例行胃癌根治术患者的临床及术中资料,根据出院后是否30 d内非计划再入院分为再入院组(61例)和非再入院组(436例),比较两组患者的临床及术中资料,用多变量Logistic回归分析再入院组的相关危险因素。结果:胃癌根治术后30 d内非计划再入院率为12.2%,比较两组患者临床资料结果显示术前合并症、切除范围、平均住院时间、术后并发症差异具有统计学意义(P<0.05),多变量Logistic回归分析结果表明患者术前合并症(OR=2.56)、切除范围(OR=1.78)、术后并发症(OR=3.24)是出院后30 d内非计划再入院的危险因素,其差异具有统计学意义(P<0.05)。结论:术前合并症、切除范围、术后并发症是胃癌根治术患者出院后30 d内非计划再入院的危险因素,非计划再入院最常见的原因为胃排空延迟和切口感染。

Objective： To investigate risk taetors and causes for unplanned readmission within 30 days after radical gastrectomy for patients with gastric cancer. Methods： A retrospective analysis of 497 patients with gastric cancer undergoing radical gastreetomy were performed. These patients were assigned into readmission group （61 cases） and non-readmission group （436 cases） according to whether or not they had been readmitted within 30 days after discharge. By comparing the clinical data of two groups, related risk taetors of readmission group were analyzed by nmhivariate logistic regression models. Results： The incidence of unplanned readmission within 30 days after radical gastreetomy was 12.2%. Comparison of clinical data between the two groups showed that preoperative eomorbidities, range of resection, average length of stay, postoperative complications were statistically significant（P〈0.05 ）. Multivariate logistic regression analysis showed that preoperative eomorbidities （OR=2.56）, resection range （OR=1.78） and postoperative complications （OR=3.24） were risk taetors tor unplanned readmission within 30 days after discharge, and the ditterenee was statistically significant. Conclusion： The preoperative eomorbidities, extent of resection and postoperative complications are the risk taetors tor unplanned readmission within 30 days after discharge. And the most common causes of unplanned readmission after radical gastreetomy are delayed gastric emptying and incision inteetion.