摘要
目的明确全膝/髋关节置换患者短期内非计划性再入院的危险因素,为护理人员提前评估并识别高危人群以便进行指导提供理论依据。方法计算机检索Pubmed、Embase、Cochrane library、Web of science、知网(CNKI)、万方(Wan fang)、维普(VIP)、中国生物医学文献数据库(CBM),搜索从建库时间至2019年12月关于全膝/髋关节置换患者短期内非计划性再入院危险因素的文献。由2位评估员独立筛选研究,提取资料,评估研究质量。采用Reveman 5.3软件进行Meta分析。结果共纳入12篇文章,其中再次入院31280例,未再次入院663626例,共纳入全关节置换患者短期内非计划性再入院危险因素19个,有统计学意义的危险因素为年龄(MD=1.50)、男性(OR=1.26)、ASA等级3~4级(OR=1.70)、BMI≥40(OR=1.53)、抑郁史(OR=4.90)、饮酒史(OR=1.48)、手术时间(MD=5.28)、术前输血史(OR=2.05)、类固醇使用史(OR=1.55)、住院时间≥5d(OR=2.82)、医保报销(OR=1.70)、近期体质量下降(OR=2.68)、高血压(OR=1.25)、糖尿病(OR=1.41)、充血性心力衰竭(OR=2.86)、肝病(OR=1.66)。结论男性、ASA等级3~4级、BMI≥40、抑郁史、饮酒史、手术时间长、术前输血史、类固醇使用史、住院时间≥5 d、医保报销、近期体质量下降、高血压、糖尿病、充血性心力衰竭、肝病是全关节置换患者短期内非计划性再入院的危险因素。提示护理人员应对相关因素采取干预,以提高医疗质量,降低医疗成本,优化医疗资源。
Objective To define the risk factors of unplanned readmission of total joint replacement patients in the short term,and provide theoretical basis for nursing staff to evaluate and identify high-risk groups in advance for guidance.Methods Pubmed,Embase,Cochrane library,Web of science,CNKI,WanFang,VIP and CBM were searched by computer for the literature on the risk factors of short-term unplanned readmission for patients with total joint replacement from the time of establishment to December 2019.Two evaluators independently screen studies,extract data and evaluate research quality.Meta analysis was performed with Reveman 5.3 analysis software.Results 12 articles were included,including 31,280 cases of readmission and 663,626 cases of non-readmission.A total of 19 risk factors for short-term unplanned readmission of total joint replacement patients were included.There was statistically significant risk factors for age(MD=1.50),male(OR=1.26),ASA grade 3 to 4(OR=1.70),BMI,40 kg/m 2 OR(OR=1.53),and a history of depression(OR=4.90),drinking history(OR=1.48),operation time(MD=5.28),preoperative blood transfusion history(OR=2.05),steroid use history(OR=1.55),length of hospital stay for five days OR more(OR=2.82),health care expenses(OR=1.70),the recent weight loss(OR=2.68),hypertension(OR=1.25),diabetes(OR=1.41),congestive heart failure(OR=2.86),and liver disease(OR=1.66).Conclusion Male,ASA level 3-4,BMI≥40 kg/m 2,history of depression,history of alcohol consumption,long operation time,history of preoperative blood transfusion,history of steroid use,length of hospitalization≥5 days,medical insurance reimbursement,recent weight loss,hypertension,diabetes,congestive heart failure and liver disease are risk factors for short-term unplanned readmission for total joint replacement patients.
作者
桂珊珊
曹亚琴
闵继康
李恒
Gui Shanshan;Cao Yaqin;Ming Jikang;Li Heng(Huzhou Normal University,Huzhou,Zhejiang 313000)
出处
《护士进修杂志》
2020年第18期1690-1696,共7页
Journal of Nurses Training
基金
浙江省基础公益研究计划项目(编号:LGF19H060002)
湖州市科技局公益性应用研究项目(编号:2016GY26)。
