摘要
目的系统评价儿童心脏手术后30 d非计划再入院率、危险因素及原因。方法检索PubMed、Embase、Web of Science、中国生物医学文献服务系统、万方数据库、中国知网和维普期刊数据库建库至2020年8月15日发表的有关儿童心脏手术后30 d非计划再入院的文献。采用RevMan5.3软件进行Meta分析。结果共纳入13项研究,包括81633例患儿。Meta分析结果显示:儿童心脏手术后30 d非计划再入院率为11.5%(95%CI 9.9%~13%);心脏并发症24.0%(95%CI 10.7%~45.7%),感染18.7%(95%CI 13.7%~25.3%),呼吸道并发症18.0%(95%CI 10.7%~27.5%),胸腔积液11.5%(95%CI 8.3%~16.7%),胃肠道并发症12.3%(95%CI 8.3%~17.4%)是患儿30 d非计划性再入院的主要原因,差异均有统计学意义(P<0.001);遗传综合征(OR=1.25,95%CI 1.18~1.33,P<0.05)、术后住院时间>14 d(OR=1.62,95%CI 1.05~2.50,P<0.05)是患儿30 d非计划性再入院的危险因素。结论儿童心脏手术后30 d非计划再入院率较高,心脏并发症、感染、呼吸道并发症、胸腔积液、胃肠道并发症是患儿30 d非计划性再入院的主要原因,遗传综合征、术后住院时间是患儿30 d非计划性再入院的危险因素。
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 81633 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.
作者
林茜
刘斌
李晓琴
刘勤
Lin Xi;Liu Bin;Li Xiaoqin;Liu Qin(Department of Pediatrics,Affiliated Hospital of Southwest Medical University,Sichuan Provincial Clinical Medical Research Center for Children with Birth Defects,Luzhou 646000,China)
出处
《中国小儿急救医学》
CAS
2021年第10期899-905,共7页
Chinese Pediatric Emergency Medicine
