Effect of Rothman index on unplanned readmission and complications in elderly patients undergoing total hip and knee arthroplasty / 中国组织工程研究

BACKGROUND:Total hip and knee arthroplasty is widely used in the elderly population,but there is a lack of accurate prediction methods for unplanned readmission and postoperative complications. OBJECTIVE:To investigate the effect of the Rothman index on unplanned readmission and complications in elderly patients undergoing total hip and knee arthroplasty. METHODS:A total of 153 patients who underwent elective total hip and knee arthroplasty from December 2020 to December 2022 in Ward Area One,Department of Orthopedics,The First People's Hospital of Zunyi were selected as the study subjects.According to whether they were unplanned readmission within 90 days after discharge,they were divided into a readmission group(n=21)and a non-readmission group(n=132).The general data of all patients were collected through the electronic medical record system,including gender,age,body mass index,diabetes mellitus,hypertension,and surgical joint type.The Rothman index was evaluated according to the literature.Postoperative complications were counted. RESULTS AND CONCLUSION:(1)There was no significant difference in gender,body mass index,surgical joint type,and length of hospital stay between the readmission group and the non-readmission group(P>0.05).There were significant differences in the number of comorbidities,age,and Rothman score between the two groups(P<0.05).(2)The results of multivariate Logistics regression analysis showed that the number of comorbidities,age,and Rothman score were independent influencing factors for readmission 90 days after total hip and knee arthroplasty in elderly patients with hip and knee diseases(P<0.05).(3)The results of receiver operating characteristic curve analysis exhibited that the area under the curve of the Rothman index for predicting readmission 90 days after total hip and knee arthroplasty was 0.824;the sensitivity was 80.85%;the specificity was 78.85%;the maximum Youden index was 0.597,and the optimal cutoff value was 46 points.(4)The incidence of total complications in elderly patients with Rothman<46 was higher than that in elderly patients with Rothman≥46(P<0.05).(5)It is concluded that the Rothman index can accurately predict unplanned readmission after total hip and knee arthroplasty in elderly patients with hip and knee joint diseases.Simultaneously,patients with Rothman index of less than 46 points have a higher overall risk of complications and poor joint recovery,which can be used to improve postoperative management of patients in clinical practice.

Research progress and enlightenment of unplanned readmission in postoperative gynecologic malignancy patients / 中国实用护理杂志

The high incidence of unplanned readmission of postoperative patients with gynecologic malignancies not only seriously affects the quality of life of patients, but also increases the medical burden. This paper reviews the current situation, common causes, relevant factors and insights of unplanned readmission of postoperative gynecologic malignancy patients, and further explores the unplanned readmission of postoperative gynecologic malignancy patients in China by drawing on existing foreign studies and combining them with the actual situation in China, with the aim of providing a basis for clinical health care professionals to develop targeted intervention plans, so as to effectively reduce the unplanned readmission of postoperative gynecologic malignancy patients.

Current status of unplanned readmission of neonates within 31 days after discharge from the neonatal intensive care unit and risk factors for readmission / 中国当代儿科杂志

OBJECTIVES@#To investigate the current status of unplanned readmission of neonates within 31 days after discharge from the neonatal intensive care unit (NICU) and risk factors for readmission.@*METHODS@#A retrospective analysis was performed on the medical data of 1 561 infants discharged from the NICU, among whom 52 infants who were readmitted within 31 days were enrolled as the case group, and 104 infants who were not readmitted after discharge during the same period of time were enrolled as the control group. Univariate analysis and multivariate logistic regression analysis were performed to identify the risk factors for readmission.@*RESULTS@#Among the 1 561 infants, a total of 63 readmissions occurred in 52 infants, with a readmission rate of 3.33%. hyperbilirubinemia and pneumonia were the main causes for readmission, accounting for 29% (18/63) and 24% (15/63) respectively. The multivariate logistic regression analysis showed that that gestational age <28 weeks, birth weight <1 500 g, multiple pregnancy, mechanical ventilation, and length of hospital stay <7 days were risk factors for readmission (OR=5.645, 5.750, 3.044, 3.331, and 1.718 respectively, P<0.05).@*CONCLUSIONS@#Neonates have a relatively high risk of readmission after discharge from the NICU. The medical staff should pay attention to risk factors for readmission and formulate targeted intervention measures, so as to reduce readmission and improve the quality of medical service.

Risk factors analysis and construction of risk prediction model for unplanned readmission in patients with acute myocardial infarction / 中国实用护理杂志

Objective:To explore the risk factors of unplanned readmission in patients with acute myocardial infarction, and to construct a risk prediction model.Methods:This study used cross-sectional survey method. A total of 270 acute myocardial infarction patients admitted from Tianjin Union Medical Cencer from March 2020 to March 2021 were evaluated in a cardiology department. We used the electronic medical record system to collect the patients′ data. Patients were divided into two groups according to the occurrence of readmission within 1 year or not. Logistic regression analysis was performed to identify risk factors and formulated prediction model.Results:Totally 81 patients (30%) were readmitted. Binary Logistic regression model showed that the independent influencing factors of unplanned readmission in acute myocardial infarction patients included smoking ( X1), hypertension ( X2), marital status ( X3), hospitalization days ( X4), percutaneous coronary intervention ( X5), and heart failure ( X6). Area under ROC curve was 0.840, the maximum value of the Youden index was 0.560, and the sensitivity was 85.2%, the specificity was 70.8%, and the cutoff value was 0.377. Prediction model expression of unplanned readmission risk in patients with acute myocardial infarction was Logit(p/1-p)=-4.012+1.172 X1+1.104 X2+0.992 X3+0.118 X4+1.191 X5+1.093 X6. Conclusions:The risk prediction model of unplanned readmission in patients with acute myocardial infarction established in this article was with a good predictive effect, and it could be used in early identification of those patients with high-risk in unplanned readmission. At the same time, combined with the risk factors of depression, targeted intervention measures can be formulated.

Unplanned readmission rate and risk factors during 30-days after cardiac surgery in children: A systematic review with Meta-analysis / 中国小儿急救医学

Objective:To systematically evaluate the rate of unplanned readmissions for children at 30 days after cardiac surgery, the causes and risk factors for unplanned readmissions for children at 30 days after cardiac surgery.Methods:We searched PubMed, Embase, Web of Science, CBM, CNKI, Wanfang Data, and VIP database to collect studies from inception to August 15, 2020 of unplanned readmission of children after cardiac surgery.RevMan5.3 software was used for Meta-analysis.Results:A total of 13 studies, involving 81 633 patients were included.Meta-analysis results showed that the unplanned readmission rate of children 30 days after cardiac surgery was 11.5%(95% CI 9.9%-13%). Cardiac complications[24%(95% CI 10.7%-45.7%)], infections[18.7%(95% CI 13.7%-25.3%)], respiratory complications[18.0%(95% CI 10.7%-27.5%)], pleural effusion[11.5%(95% CI 8.3%-16.7%)], and gastrointestinal complications[12.3%(95% CI 8.3%-17.4%)] were the main reasons for unplanned 30-day readmission, with statistically significant differences( P<0.001). Genetic syndrome( OR=1.25, 95% CI 1.18-1.33, P<0.05) and postoperative hospital stay >14 days( OR=1.62, 95% CI 1.05-2.50, P<0.05) were risk factors for unplanned 30-day readmission. Conclusion:The incidence rate of unplanned readmission among the children 30 days after cardiac surgery is relatively high.Cardiac complications, infection, respiratory complications, pleural effusion, and gastrointestinal complications are the main reasons for 30-day unplanned readmission.The genetic syndrome and postoperative hospital stay >14 days in children 30 days after cardiac surgery are the risk factors for unplanned readmission.