结直肠癌手术患者住院超30天影响因素

Analysis on Influencing Factors and Establishment of Predictive Model for Patients with Colorectal Cancer Hospitalized for More Than 30 Days

目的 分析结直肠恶性肿瘤手术患者住院超30天影响因素,为合理控制住院天数提供参考依据。方法 选取某三甲医院2015年1月1日-2019年12月31日出院的结直肠癌恶性肿瘤首次手术的1093病例作为研究对象,其中住院超30天患者作为研究组,未超30天患者作为对照组,收集19个可能影响住院超30天的因素,采用SPSS20.0统计学软件进行单因素分析及多因素Logistic回归分析。结果 单因素分析结果显示不同性别、医疗付费方式、入院途径、术前住院天数、手术级别、手术方式、合并高血压、合并糖尿病、合并心脏病、有无抢救、是否造口、是否输血、是否非计划再次手术、有无并发症组间比较有差异;经多因素Logistics回归分析,术前住院天数≥7天(OR=4.462)、手术方式(OR=1.914)、合并高血压(OR=2.076)、输血(OR=1.915)、并发症(OR=4.282)、非计划再次手术(OR=16.364)是住院超30天的独立影响因素。结论术前住院天数≥7天、开腹手术、患者合并高血压、输血、术后并发症和非计划再次手术是住院超30天的影响因素,应重点关注。建议强化结直肠手术患者围手术期管理,降低住院天数,减轻患者痛苦,减少住院花费。

Objectives To analyze the influencing factors for patients with colorectal cancer who had been hospitalized for more than 30 days,and provide reference for rational control of hospitalization days.Method A total of 1093 patients with colorectal cancer who were discharged from a first-class hospital from January 1st,2015 to December 31st,2019 were selected as the study subjects,including patients who had been hospitalized for more than 30 days as the study group and patients who had not been hospitalized for more than 30 days as the control group,to collect 18 factors which may affect hospitalization for more than 30 days,SPSS20.0 statistical software was used for single factor analysis and multiple factor logistic regression analysis.Results Single factor analysis revealed there were significant differences in gender,medical payment method,admission route,length of pre-operative stay,operative grade,operative method,hypertension,diabetes,heart disease,rescue,stoma,transfusion,unplanned reoperation complication.After multi-factor logistic regression analysis,preoperative hospitalization more than 7 days(OR=4.462),operative methods(OR=1.914),combined hypertension(OR=2.076),blood transfusion(OR=1.915),complications(OR=4.282),unplanned reoperation(OR=16.364) were the independent influencing factors.Conclusions Preoperative hospitalization stay more than 7 days,laparotomy,patients complicated with hypertension,blood transfusion,postoperative complications and unplanned re-operation were the influencing factors of hospital stay over 30 days,which should be paid more attention to,it was suggested to strengthen the perioperative management of patients with colorectal surgery,reduce the length of stay,ease the pain of patients and reduce the cost of hospitalization.