实用老年医学

实用老年医学 ›› 2022, Vol. 36 ›› Issue (4): 378-381.doi: 10.3969/j.issn.1003-9198.2022.04.013

• 临床研究 • 上一篇    下一篇

老年胃癌根治术后病人出院30天内非计划再入院的危险因素分析

刘子婕, 曹勤洪, 姚学权   

  1. 210029 江苏省南京市,南京中医药大学(刘子婕);
    210029 江苏省南京市,江苏省中医院肿瘤外科(曹勤洪,姚学权)
  • 收稿日期:2021-05-11 出版日期:2022-04-20 发布日期:2022-04-26
  • 通讯作者: 姚学权,Email:1063130559@qq.com

Analysis of risk factors for 30-day unplanned readmission after radical gastrectomy for gastric cancer in elderly

LIU Zi-Jie, CAO Qin-hong, YAO Xue-quan   

  1. LIU Zi-Jie. Nanjing University of Chinese Medicine, Nanjing 210029, China;
    CAO Qin-hong, YAO Xue-quan. Department of Gastrointestinal Oncology Surgery, Jiangsu Province Hospital of Chinese Medicine, Nanjing 210029, China
  • Received:2021-05-11 Online:2022-04-20 Published:2022-04-26

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摘要： 目的 探讨老年胃癌根治术后病人出院30 d内非计划再入院的发生率、原因及危险因素。方法 收集 626例2009～2019年在我院接受根治性胃癌切除术老年病人的临床及手术相关资料,根据出院后30 d内是否发生非计划再入院分为再入院组(19例)和未再入院组(607例),比较2组的资料,分析胃癌根治术后出院30 d内非计划再入院的危险因素。 结果 626例病人中有19例病人(3.04%)在首次出院后30 d内再次入院,再入院的中位时间为10 d。再次入院的原因有腹胀7例(36.84%)、感染6例(31.58%)、吻合口瘘3例(15.79%)、肠梗阻2例(10.53%)、肾功能不全1例(5.26%)。再入院组术前白蛋白水平、Karnofsky功能状态评分(KPS)、手术时间、术后并发症严重程度与未再入院组比较,差异有统计学意义(P＜0.05)。Logistic回归分析显示,术前KPS评分(OR=0.971,95%CI:0.949～0.993,P=0.011)、术后并发症(OR=4.895,95%CI:1.843～12.999,P=0.001)是病人30 d内非计划再入院的独立影响因素。 结论 老年胃癌根治术后病人出院30 d内非计划再入院的发生率为3.04%,术前KPS评分及术后并发症是影响其出院后30 d内非计划再入院的独立危险因素。

关键词: 胃癌, 老年人, 非计划再入院, 危险因素

Abstract: Objective To investigate the incidence, causes and risk factors for 30-day unplanned readmission after radical gastrectomy for gastric cancer in the elderly. Methods The clinical and surgical-related data of 626 elderly patients underwent radical gastric cancer surgery in our hospital from 2009 to 2019 were collected.All the patients were divided into the readmission group(19 cases) and the non- readmission group(607 cases) according to whether they were readmitted within 30 days after discharge, and the data of the two groups were compared to analyze the risk factors for 30-day unplanned readmission after radical gastrectomy for gastric cancer in the elderly. Results There were 19 patients(3.04%) readmitted within 30 days after initial discharge, with a median time of 10 d. Reasons for readmission were abdominal distention(n=7), infection(n=6), anastomotic fistula(n=3), intestinal obstruction(n=2), and renal insufficiency(n=1). There were significant differences in preoperative albumin level, Karnofsky Performance Status (KPS) score, operative time, and severity of postoperative complications between the readmission group and the non-readmission group(P<0.05). Logistic regression analysis showed that KPS score(OR=0.971, 95%CI: 0.949-0.993, P=0.011) and postoperative complications(OR=4.895, 95%CI: 1.843-12.999, P=0.001) were independent risk factors for 30-day unplanned readmission. Conclusions The incidence of unplanned readmission is 3.04%, and the KPS scores and postoperative complications are the independent risk factors for 30-day unplanned readmission after radical gastrectomy for gastric cancer in the elderly.

Key words: gastric cancer, aged, unplanned readmission, risk factors

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