Abstract：
Introduction: The optimal strategy to reduce short-term readmission rates following colectomy remains unclear. Identifying possible risk factors can minimize the burden associated with surgical complications leading to readmissions. Materials and Methods: A retrospective review of all adult patients who underwent colectomies between January 2008 and December 2020 in a large tertiary medical center was conducted. Data were collected from patient\'s medical charts and analyzed. Results: Overall, 2547 patients were included in the study (53% females; mean age 68.3 years). The majority of patients (83%, n = 2112) were operated in an elective setting, whereas 435 patients (17%) underwent emergency colonic resection. Overall, the 30-day readmission rate was 8.3% (n = 218) with an overall 30-day mortality rate of 1.65% (n = 42). Multivariable analysis of possible risk factors for 30-day readmission demonstrated that patient age (odds ratio [OR] 0.98; P = .002), length of stay before surgery (OR 1.01; P = .003), and blood transfusion rate during hospitalization (OR 2.09; P < .001) were all independently associated with an increased risk. Laparoscopic colectomy (OR 0.53; P = .001) was associated with a reduced risk for readmission. Multivariable analysis of risk factors for mortality showed that age (OR 1.10; P < .001), cognitive decline (OR 12.35; P < .001), diabetes (OR 1.00; P = .004), and primary ostomy formation (OR 2.80; P = .006) were all associated with higher mortality. Conclusion: Patient age, history of cognitive decline, and blood transfusion along with a longer hospital stay were all correlated with an increased risk for 30-day patient readmission following colectomy.
摘要：
简介：降低结肠切除术后短期再入院率的最佳策略尚不清楚。确定可能的风险因素可以最大程度地减少与导致再入院的手术并发症相关的负担。材料和方法：对2008年1月至2020年12月在大型三级医疗中心接受结肠切除术的所有成年患者进行回顾性分析。从患者的医疗图表中收集数据并进行分析。结果：总体而言，2547名患者被纳入研究(53%为女性;平均年龄68.3岁)。大多数患者（83%，n=2112)在选择性设置下操作，而435例患者（17％）接受了紧急结肠切除术。总的来说,30日再入院率为8.3%(n=218),总体30日死亡率为1.65%(n=42).30天再入院的可能危险因素的多变量分析表明，患者年龄（比值比[OR]0.98;P=0.002），手术前住院时间（OR1.01；P=0.003），住院期间输血率（OR2.09;P<.001）均与风险增加独立相关。腹腔镜结肠切除术（OR0.53；P=.001）与再入院风险降低相关。死亡危险因素的多变量分析显示年龄(OR1.10;P<.001),认知能力下降（OR12.35；P<.001），糖尿病（OR1.00；P=.004），和原发性造口形成(OR2.80;P=.006)均与较高的死亡率相关。结论:患者年龄,认知衰退的历史，输血和住院时间延长均与结肠切除术后30天患者再入院风险增加相关.
