Predictors of hospital readmission among older adults with cancer.
Predictors of hospital readmission among older adults with cancer.
复制标题
DOI：
10.1016/j.jgo.2020.03.008
复制
发表时间：
2020-09
影响因子：
3
通讯作者：
Hurria A
中科院分区：
文献类型：
--
作者：
Burhenn P;Sun CL;Scher KS;Hsu J;Pandya P;Chui CY;Arsenyan A;Mitani D;Morrison R;Katheria V;Hurria A
患有癌症的老年人再次入院的风险更高，费用高昂，而且有潜在的危险。识别这一人群再入院的风险因素对于未来预防再入院非常重要。在这项匹配病例对照研究中，对2006-2011年接受非手术治疗的≥ 65岁实体瘤患者的出院情况进行了审查。我们从病历中提取患者/癌症特征、功能状态、跌倒风险、化疗线、合并症、实验室检查值、出院参数和其他信息（不要复苏顺序、疼痛评分）。采用条件Logistic回归进行单因素和多因素分析。该分析包括184例在指数入院出院后30天内再次入院的病例患者和184例在没有再次入院的病例的3个月内从指数入院出院的性别和年龄匹配的对照患者。病例组和对照组在原发癌类型、治疗和入院原因方面无差异。出院时血红蛋白、白蛋白、钠和SGOT异常的病例更多。与有≤1项实验室检查异常的患者相比，有2项或2项以上异常检查结果的患者在30天内再次入院的可能性高3倍。这项研究表明，出院时至少有2项异常实验室结果（血红蛋白、白蛋白、钠和SGOT）的老年癌症患者在30天内再次入院的可能性是≤1项异常结果患者的3倍。这些实验室检查值可以预测再入院的风险，出院前应进行监测，以预防再入院。
Older adults with cancer are at higher risk for costly and potentially dangerous hospital readmissions. Identifying risk factors for readmission in this population is important for future prevention of readmission. Hospital discharges among patients ≥ 65 years with solid tumors on non-surgical services from 2006–2011 were reviewed in this matched case-control study. We abstracted patient/cancer characteristics; functional status; fall risk; chemotherapy line; comorbidities; laboratory values; discharge parameters; and miscellaneous information (Do Not Resuscitate Order, pain scores) from medical records. Conditional logistic regression was used for univariate and multivariable analysis. This analysis included 184 case-patients readmitted within 30 days after discharge from the index admission and 184 sex- and age-matched control-patients discharged from index admission within three months of the cases with no readmission. Cases and controls had no differences in terms of primary cancer type, treatment, and index admission reason. Cases were more likely to have abnormal hemoglobin, albumin, sodium, and SGOT on discharge. Compared to those with ≤1 abnormal laboratory test, patients with 2 or more abnormal test results were 3 times more likely to be readmitted within 30 days. This study demonstrated that older adults with cancer who had at least 2 abnormal laboratory results (hemoglobin, albumin, sodium, and SGOT) at discharge were 3 times more likely to be readmitted within 30 days compared to those with ≤1 abnormal results. These laboratory values may be predictive of the risk of readmission, and should be monitored before discharge to potentially prevent readmission.
登录
查看更多内容
DOI：
10.1097/00001648-199001000-00010
发表时间：
1990-01-01
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
Rothman, K J
通讯作者：
Rothman, K J
影响因子：
--
作者：
Bursac, Zoran;Gauss, C Heath;Williams, David Keith;Hosmer, David W
通讯作者：
Hosmer, David W
影响因子：
45.3
作者：
Brooks, Gabriel A.;Abrams, Thomas A.;Schrag, Deborah
通讯作者：
Schrag, Deborah
影响因子：
4.8
作者：
Muzzarelli, Stefano;Leibundgut, Gregor;Brunner-La Rocca, Hans-Peter
通讯作者：
Brunner-La Rocca, Hans-Peter
影响因子：
5.9
作者：
Marcantonio, ER;McKean, S;Brennan, TA
通讯作者：
Brennan, TA