摘要
目的 探讨脊柱转移瘤(SM)患者术后再入院和再手术(RDRP)的驱动因素.方法 选择2015年1月至2021年12月在该院接受手术治疗的203例SM患者临床资料进行回顾性分析,根据是否RDRP将患者分为RDRP组和非RDRP组,采用t检验、非参数检验、卡方检验等进行单因素分析,采用Logistic回归模型进行多因素分析,观察影响SM患者术后发生RDRP的独立风险因素.结果 203例患者中,有34例出院后30 d内非计划内再次入院,发生率为16.75％.单因素分析显示,RDRP和非RDRP组患者的年龄、性别、体质量指数、吸烟、糖尿病、高血压、原发肿瘤部位、KPS评分、术前栓塞、术前WBC、Hb、PLT、MPV、手术入路、切口长度、输血及器械应用等差异均无统计学意义(P＞0.05);RDRP组患者改良查尔森共病指数(CCI)、ASA分级＞2级、术前放疗、住院时间、RDW等指标数据均高于非RDRP组患者(P＜0.05).多因素Logistic回归分析结果显示,仅改良CCI是SM患者术后发生RDRP的风险因素(P＜0.05).结论 改良CCI是SM手术患者术后30 d内发生RDRP的重要风险因素.
Abstract
Objective To investigate the driving factors of readmission and reoperation(RDRP)after spinal metastasis(SM).Methods The clinical data of 203 patients with SM who underwent surgery in our hospital from January 2015 to December 2021 were retrospectively analyzed.According to whether RDRP was used,the patients were divided into RdRp group and non RdRp group.T-test,nonparametric test and chi square test were used for univariate analysis,logistic regression analysis was used for multivariate anal-ysis,and the independent risk factors affecting RDRP were observed.Results Among 203 patients,34 patients were hospitalized un-planned within 30 days after discharge,with an incidence of 16.75％.Univariate analysis showed that there was no significant differ-ence in age,sex,body mass index,smoking,diabetes,hypertension,primary tumor location,KPS score,preoperative embolization,preoperative WBC,Hb,PLT,MPV,surgical approach,incision length,blood transfusion and instrument application between RDRP and non RDRP groups(P＞0.05).The improved Charlson Comorbidity Index(CCI),ASA＞grade 2,preoperative radiotherapy,length of hospital stay and RDW in RDRP group were higher than those in non RDRP group(P＜0.05).Multivariate logistic analysis showed that only modified CCI was the risk factor of RDRP(P＜0.05).Conclusion Modified CCI is an important risk factor for RdRp in patients with SM within 30 days.
维普
万方数据