低风险病种超长住院日的影响因素分析

Analysis of Influencing Factors of Low-risk Diseases Inpatients with Extra-long Hospitalization Days

目的分析低风险病种超长住院日的影响因素,为控制低风险病种住院时间提供依据。方法收集某三甲医院2015年1月1日—2020年12月31日低风险病种超长住院(住院时间>30天)患者1626例作为病例组,以病种、性别、年龄为匹配条件,按照完全随机抽样的方法抽取低风险病种(住院日≤30天)患者6504例为对照组,收集两组的性别、年龄、合并症、手术、转科、感染等病史资料,采用单因素分析、多因素logistic回归分析等方法对其进行统计分析,探讨导致低风险病种患者超长住院的影响因素。结果病例组平均住院日中位数为46.0天,共覆盖60个病种,前十位病种人数占总超长住院日患者数的82.96%;单因素分析结果显示,合并症、手术、转科、感染组间差别有统计学意义(P<0.05);多因素Logistic回归分析显示,合并症(OR=2.99,95%CI:1.93~4.63)、手术(OR=4.64,95%CI:4.06~5.31)、转科(OR=5.84,95%CI:4.91~6.96)、感染(OR=3.04,95%CI:2.61~3.54)是低风险病种超长住院日的独立影响因素。结论低风险病种住院患者存在合并症、住院期间手术、转科和发生感染均是产生超长住院日的重要原因,医院应对低风险病种开展多学科联合诊疗、防控感染和加强手术管理等措施控制低风险病种患者的住院时间。

Objectives Analysis of influencing factors of low-risk diseases inpatients with extra-long hospitalization days,and provide basis for controlling extra-long hospitalization days of low-risk diseases.Methods To collected inpatients with extra-long hospitalization days of low-risk disease from January 1st,2015 to December 31st,2020 in a tertiary hospital,a total of 1626 cases(hospitalization time>30 days)were taken as the case group,match it to the disease,sex and age,a total of 6504 inpatients(length of stay≤30 days)with low-risk diseases were randomly selected as control group,The data of sex,age,complications,surgery,transfer and infection were collected,The data were analyzed by single factor analysis and multiple logistic regression analysis,to explore the influencing factors of long duration of hospitalization in patients with low-risk diseases.Results There were 1626patients with low-risk diseases with super long hospitalization days,and the median length of stay(M)was 46.0d,covering 60 diseases.The top ten diseases accounted for 82.96%of the total patients with extra-long hospitalization days;Univariate analysis showed that there were significant differences in complications,operation,transfer of department,infection(all P<0.05);multiple logistic regression analysis showed that complication(OR=2.99,95%CI:1.93~4.63),operation(OR=4.64,95%CI:4.06~5.31),transfer of department(OR=5.84,95%CI:4.91~6.96),infection(OR=3.04,95%CI:2.61~3.54)were the independent influencing factors of extra-long hospitalization.Conclusions Complications of hospitalized patients with low-risk diseases,surgery during hospitalization,transfer and infection were important reasons for the extra-long hospitalization days.Hospitals should carry out multi-disciplinary joint diagnosis and treatment for low-risk diseases,prevent and control infection and strengthen surgical management to control the extra-long hospitalization days with low-risk diseases.