首页|期刊导航|中华医学杂志（英文版）|Multivariable analysis of factors associated with hospital readmission following pancreaticoduodenectomy for malignant diseases
中华医学杂志（英文版）2011，Vol.124Issue(7)：1022-1025,4.DOI:10.3760/cma.j.issn.0366-6999.2011.07.014
Multivariable analysis of factors associated with hospital readmission following pancreaticoduodenectomy for malignant diseases
Multivariable analysis of factors associated with hospital readmission following pancreaticoduodenectomy for malignant diseases
摘要
Abstract
Background Readmission rates after pancreaticoduodenectomy (PD) for malignant diseases have a significant impact on survival rate. Identification of risk factors for readmission may improve discharge plans and postoperative care. Data exist on the morbidity and mortality of patients undergoing PD,but there are few reports about hospital readmissions after this procedure. Our aims were to evaluate the proportion and reasons for readmissions after PD for malignant diseases,the factors influencing readmissions,and to analyze the relationship between readmission rate and survival rate.Methods Four hundred and thirty-six patients,who had undergone PD for malignant diseases in our centre from October 1999 to October 2009,a 10-year period,excluding perioperative (30-day) mortality,were identified. All readmissions within 1 year following PD were analyzed with respect to timing,location,reasons for readmission and outcome. We reviewed the hospitalization and readmissions for patients undergoing PD,and compared patients requiring readmission to patients that did not require readmission.Results One hundred and forty-five patients (33.26%) were readmitted within 1 year following PD,for further treatment or complications. In those cases,diagnoses associated with high rates of readmission included radiation and/or chemotherapy (48.96%),progression of disease (11.72%),infection (11.72%),gastrointestinal dysfunction/obstruction (6.20%),surgery-related complications (2.76%) and pain (4.14%). The proportion of T4 in readmission group was lower than no readmission group (P ＜0.05). The proportion of node positive cases in readmission group was much higher than no readmission group (P ＜0.01).The number of readmission for complications reduced gradually in the first three months,and reached a second peak in the sixth and seventh month. Median survival was lower for the readmission group compared with the no readmission group (21 versus 46 months,P=0.024).Conclusion These results may assist in both anticipating and facilitating postoperative care as well as managing patient expectations.关键词
pancreaticoduodenectomy/readmission/complications/survival rateKey words
pancreaticoduodenectomy/readmission/complications/survival rate引用本文复制引用
ZHU Zi-yi,HE Ji-kai,WANG Yi-fan,LIANG Xiao,YU Hong,WANG Xian-fa,CAI Xiu-jun..Multivariable analysis of factors associated with hospital readmission following pancreaticoduodenectomy for malignant diseases[J].中华医学杂志（英文版）,2011,124(7):1022-1025,4.基金项目
This research was supported by grants from the National High Technology Research and Development Program ("863" Program)of China (No.2007AA02Z446) and the Public Health Ministry Profession Funds (No.200802004). （"863" Program）
