The Frequency of Unplanned Rehospitalization and Associated Factors in Gyneoncology Patients: A Retrospective Study.

Gul Pinar, Ayse Akalin, Hulya Erbaba, Gokce Banu Acar, Filiz Avsar, Tevfik Pinar
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Abstract

Objective: In this study, we aim to analyze rate and associated factors with unplanned rehospitalization in gynecological cancer patients.

Materials and methods: The electronic database query (2007 to 2014) was used to evaluate rehospitalization rates within 90 days of index admission in patients with gynecological cancer. Multivariable logistic regression was used to identify factors associated with rehospitalization.

Results: Mean patient age was 59.05 ± 11.96 years (minimum, 32 years; maximum, 85 years). A total of 152 patients' data were evaluated. Seventy-three patients (48.0%) were rehospitalized within 90 days of discharge. The median length of index hospital stay (from 3 to 34 days) was 8.90 ± 6.03 days. The most common rehospitalization causes includes pain (24.6%), recurrence (21.9%), ascites (13.7%), surgical site infection (12.3%), acute reoperation (9.6%), thromboembolism (8.2%), renal failure (5.5%), ileus/obstruction (2.7%), and lymphedema (1.4%). In multivariable logistic regression model, difference was found between history of operation, receive chemotherapy, development of the complication during hospitalization comorbidities as well as multiparity variables, and rehospitalization (P < 0.05).

Conclusions: Unplanned rehospitalization after discharge for gynecological cancer is common with significant associated risk factors and patient outcomes. Integrated multidisciplinary health care strategies, such as safe transition, communication, patient and family education, accurate medication reconciliation, and short-interval outpatient follow-up may help to prevent rehospitalization after discharge and improve patient outcomes.

妇科患者非计划再住院频率及相关因素的回顾性研究
目的:分析妇科肿瘤患者非计划再住院率及相关因素。材料与方法:采用2007 - 2014年电子数据库查询,评价妇科肿瘤患者指数入院后90天内的再住院率。采用多变量logistic回归来确定与再住院相关的因素。结果:患者平均年龄59.05±11.96岁(最小32岁;最长85年)。总共评估了152例患者的数据。73例(48.0%)患者出院后90天内再次住院。指标住院时间中位数(3 ~ 34天)为8.90±6.03天。最常见的再住院原因包括疼痛(24.6%)、复发(21.9%)、腹水(13.7%)、手术部位感染(12.3%)、急性再手术(9.6%)、血栓栓塞(8.2%)、肾衰竭(5.5%)、肠梗阻/梗阻(2.7%)和淋巴水肿(1.4%)。在多变量logistic回归模型中,手术史、是否接受化疗、住院期间合并症的发生及多产次变量与再住院的差异有统计学意义(P < 0.05)。结论:妇科肿瘤患者出院后非计划再住院是常见的,其危险因素与患者预后有显著相关性。综合多学科卫生保健策略,如安全转移、沟通、患者和家庭教育、准确的药物调节和短间隔门诊随访,可能有助于预防出院后再住院和改善患者预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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