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目的探讨出院患者31天内因相同或相关疾病非计划再住院的原因及影响因素。方法基于2015年1月-2015年6月手术科室出院患者的电子病案资料,运用根因分析法和二分类变量的logistic回归,对31天内因相同或相关疾病非计划再住院患者的原因和影响因素进行分析。结果出院患者再住院的原因主要有术后感染、病情反复、术后出血、术后不适、术后水肿或积液、术后吻合口水肿或瘘、术后切口脂肪液化、其他等,其中前四者占75.86%;其危险因素主要有住院天数、疾病权重和手术,回归方程为:Logit P=-5.379+0.019 X_1+0.241 X_2+0.909 X_3。结论通过加强围手术期管理、严格执行资格准入、加强医师技能培训、重视术后感染控制、鼓励开展新技术和新项目、积极开展健康教育和随访等措施,减少31天非计划再住院的发生。
Objective To investigate the causes and influential factors of unplanned readmission for the same or related diseases within 31 days of discharged patients. Methods Based on the electronic medical record data of patients discharged from surgery department in January 2015 to June 2015, the causes and effects of unplanned rehospitalization for the same or related diseases within 31 days were analyzed using logistic regression analysis of root cause and dichotomous variables Factors for analysis. Results The main causes of hospital discharge were postoperative infection, repeated illness, postoperative bleeding, postoperative discomfort, postoperative edema or effusion, postoperative anastomotic edema or fistula, incision fat liquefaction and others. Among them, The four factors accounted for 75.86%. The main risk factors were length of stay, disease weight and operation. The regression equation was Logit P = -5.379 + 0.019 X_1 + 0.241 X_2 + 0.909 X_3. Conclusions By reducing perioperative management, strictly implementing eligibility for admission, strengthening medical skills training, attaching importance to postoperative infection control, encouraging new technologies and new projects, and actively implementing health education and follow-up measures to reduce 31-day unplanned readmission occur.