慢性肠系膜缺血血管内或手术血运重建术后30天再入院:来自全国再入院数据库的见解

Vascular Medicine (London, England) Pub Date : 2019-06-01 Epub Date: 2019-02-10 DOI:10.1177/1358863X18816816
Fabio V Lima, Dhaval Kolte, David W Louis, Kevin F Kennedy, J Dawn Abbott, Peter A Soukas, Omar N Hyder, Shafiq T Mamdani, Herbert D Aronow
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引用次数: 7

摘要

目前关于慢性肠系膜缺血(CMI)血运重建术后再入院的数据有限。本研究旨在确定CMI患者血管内或手术血运重建术后30天再入院的比率、原因、预测因素和费用。2013年至2014年期间血管内或手术血运重建术后出院的CMI患者来自全国再入院数据库。比率、原因、住院时间和30天全因非选择性再入院的费用使用加权的国家估计来确定。采用分层逻辑回归确定30天再入院的独立预测因子。在4671例接受肠系膜血运重建术的CMI患者中,19.5%的患者在出院后30天内再次入院,平均时间为10天。超过25%的再入院患者是心脑血管疾病,其中大多数是外周或内脏动脉粥样硬化和充血性心力衰竭。30天再入院的独立预测因素包括非选择性指标入院、慢性肾脏疾病(CKD)和出院到家庭保健或到专业护理机构。血运重建方式不能独立预测再入院。在全国范围内,对接受血管重建术的CMI患者进行回顾性分析,大约五分之一的患者在30天内再次入院。预测因子在很大程度上是不可修改的,包括非选择性指标入院、CKD和出院处置。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Thirty-day readmission after endovascular or surgical revascularization for chronic mesenteric ischemia: Insights from the Nationwide Readmissions Database.

There are limited contemporary data on readmission after revascularization for chronic mesenteric ischemia (CMI). This study aimed to determine the rates, reasons, predictors, and costs of 30-day readmission after endovascular or surgical revascularization for CMI. Patients with CMI discharged after endovascular or surgical revascularization during 2013 to 2014 were identified from the Nationwide Readmissions Database. The rates, reasons, length of stay, and costs of 30-day all-cause, non-elective, readmission were determined using weighted national estimates. Independent predictors of 30-day readmission were determined using hierarchical logistic regression. Among 4671 patients with CMI who underwent mesenteric revascularization, 19.5% were readmitted within 30 days after discharge at a median time of 10 days. More than 25% of readmissions were for cardiovascular or cerebrovascular conditions, most of which were for peripheral or visceral atherosclerosis and congestive heart failure. Independent predictors of 30-day readmission included non-elective index admission, chronic kidney disease (CKD), and discharge to home healthcare or to a skilled nursing facility. Revascularization modality did not independently predict readmission. In a nationwide, retrospective analysis of patients with CMI undergoing revascularization, approximately one in five were readmitted within 30 days. Predictors were largely non-modifiable and included non-elective index admission, CKD, and discharge disposition.

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