结直肠癌患者术后非计划性再入院影响因素及对策
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摘要
文章从患者、疾病、医院3个方面综述了结直肠癌患者非计划性再入院的影响因素,并结合各影响因素以及国外预防结直肠癌患者非计划性再入院措施对我国的预防措施提出针对性的建议,包括实施个体化营养干预、加强疾病管理及实施延续护理。
The article summarized the influencing factors of unplanned readmission with colorectal cancer from patients,disease and hospital aspects.Then,it combined the influencing factors with the prevention measures of unscheduled readmission for patients with colorectal cancer in foreign countries,and put forward suggestions pertinent to our country,including the implementation of individualized nutritional interventions,strengthening disease management and having continuing care.
The article summarized the influencing factors of unplanned readmission with colorectal cancer from patients,disease and hospital aspects.Then,it combined the influencing factors with the prevention measures of unscheduled readmission for patients with colorectal cancer in foreign countries,and put forward suggestions pertinent to our country,including the implementation of individualized nutritional interventions,strengthening disease management and having continuing care.
引文
[1] DEWDNEY A,CUNNINGHAM D,CHAU I.Selecting patients with locally advanced rectal cancer for neoadjuvant treatments trategies[J].The Oncologist,2013,8(7):833-842.DOI:10.1634/theoncologist.2013-0022.
[2] JUSTINIANO C,TEMPLE L,SWANGER A,et al.Readmissions with dehydration after ileostomy creation:rethinking risk factors[J].Diseases of the Colon and Rectum,2018,61(11):1297-1305.DOI:10.1097/DCR.0000000000001137.
[3] WEINBERG B A,MARSHALL J L,SALEM M E.The growing challenge of young adults with Ccolorectal cancer[J].Oncology(Williston Park),2017,31(5):381-389.
[4] CHEN W,ZHENG R,ZENG H,et al.The incidence and mortality of major cancers in China,2012[J].Chinese Journal of Cancer,2016,35(1):73.DOI:10.1186/s40880-016-0137-8.
[5] 邓丽娜,刘涛,张会君.老年结肠造口患者家属疾病不确定感及影响因素分析[J].中华护理杂志,2015,50(9):1047-1051.DOI:10.3761/j.issn.0254-1769.2015.09.004.
[6] JOYNT K E,JHA A K.A path forward on medicare readmissions[J].The New England Journal of Medicine,2013,368(13):1175-1177.DOI:10.1056/NEJMp1300122.
[7] DAMLE R N,ALAVI K.Risk factors for 30-d readmission after colorectal surgery:a systematic review[J].Journal of Surgical Research,2016,200(1):200-207.DOI:10.1016/j.jss.2015.06.052.
[8] SURI M F,QURESHI A I.Readmission within 1 month of discharge among patients with acute ischemic stroke:results of the University Health System Consortium Stroke Benchmarking study[J].Journal of Vascular and Interventional Neurology,2013,6(2):47-51.
[9] GREENBLATT D Y,WEBER S M,O'CONNOR E S,et al.Readmission after colectomy for cancer predicts one-year mortality[J].Annals of Surgery,2010,251(4):659-669.DOI:10.1097/SLA.0b013e3181d3d27c.
[10] WICK E C,SHORE A D,HIROSE K,et al.Readmission rates and cost following colorectal surgery[J].Diseases of the Colon and Rectum,2011,54(12):1475-1479.DOI:10.1097/DCR.0b013e31822ff8f0.
[11] LI L T,MILLS W L,WHITE D L,et al.Causes and prevalence of unplanned readmissions after colorectal surgery:a systematic review and meta-analysis[J].Journal of the American Geriatrics Society,2013,61(7):1175-1181.DOI:10.1111/jgs.12307.
[12] LOHSIRIWAT V.The influence of preoperative nutritional status on the outcomes of an enhanced recovery after surgery (ERAS) programme for colorectal cancer surgery[J].Techniques in Coloproctology,2014,18(11):1075-1080.DOI:10.1007/s10151-014-1210-4.
[13] LOOIJAARD S M L M,SLEE-VALENTIJN M S,OTTEN R H J,et al.Physical and nutritional prehabilitation in older patients with colorectal carcinoma:a systematic review[J].Journal of Geriatric Physical Therapy,2018,41 (4):236-244.DOI:10.1519/JPT.0000000000000125.
[14] SHARMA Y,MILLER M,KAAMBWA B,et al.Factors influencing early and late readmissions in Australian hospitalised patients and investigating role of admission nutrition status as a predictor of hospital readmissions:a cohort study[J].BMJ Open,2018,8(6):e022246.DOI:10.1136/bmjopen-2018-022246.
[15] GRANDA-CAMERON C,BEHTA M,HOVINGA M,et al.Risk factors associated with unplanned hospital readmissions in adults with cancer[J].Oncology Nursing Forum,2015,42(3):E257-E268.DOI:10.1188/15.ONF.E257-E268.
[16] DOUMOURAS A G,TSAO M W,SALEH F,et al.A population-based comparison of 30-day readmission after surgery for colon and rectal cancer:how are they different?[J].Journal of Surgical Oncology,2016,114(3):354-360.DOI:10.1002/jso.24334.
[17] HYDE L Z,AL-MAZROU A M,KURITZKES B A,et al.Readmissions after colorectal surgery:not all are equal[J].International Journal of Colorectal Disease,2018,33(12):1667-1674.DOI:10.1007/s00384-018-3150-3.
[18] POELEMEIJER Y Q M,LIJFTOGT N,DETERING R,et al.Obesity as a determinant of perioperative and postoperative outcome in patients following colorectal cancer surgery:a population-based study (2009-2016)[J].European Journal of Surgical Oncology,2018,44(12):1849-1857.DOI:10.1016/j.ejso.2018.05.027.
[19] CAAN B J,MEYERHARDT J A,KROENKE C H,et al.Explaining the obesity paradox:the association between body composition and colorectal cancer survival (C-SCANS Study)[J].Cancer Epidemiol Biomarkers Prevention,2017,26(7):1008-1015.DOI:10.1158/1055-9965.EPI-17-0200.
[20] ADAMOVá Z,BáR T.Influence of overweight and obesity on complications in colorectal surgery[J].Rozhledy Chirurgii Summer,2018,97(10):464-468.
[21] FRANCIS N K,MASON J,SALIB E,et al.Factors predicting 30-day readmission after laparoscopic colorectal cancer surgery within an enhanced recovery programme[J].Colorectal Disease,2015,17(7):148-154.DOI:10.1111/codi.13002.
[22] LAWSON E H,HALL B L,LOUIE R,et al.Association between occurrence of a postoperative complication and readmission:implications for quality improvement and cost savings[J].Annals of Surgery,2013,258(1):10-18.DOI:10.1097/SLA.0b013e31828e3ac3.
[23] SHAFFER R,BACKHUS L,FINNEGAN M A,et al.Thirty-day unplanned postoperative inpatient and emergency department visits following thoracotomy[J].The Journal of Surgical Research,2018,230:117-124.DOI:10.1016/j.jss.2018.04.065.
[24] YANG J,XIAO J,FENG J,et al.One-year unplanned readmission after colorectal cancer surgery in western China[J].Journal of Investigative Surgery,2018,31(17):1-5.DOI:10.1080/08941939.2018.1443176.
[25] RATTAN R,PARRECO J,LINDENMAIRE L B,et al.Underestimation of unplanned readmission after colorectal surgery:a national analysis[J].Journal of the American College of Surgeons,2018,226(4):382-390.DOI:10.1016/j.jamcollsurg.2017.12.012.
[26] 王志霞,徐惠丽,李静,等.急诊肠造口患者术后非计划性再入院现状及影响因素研究[J].中华护理教育,2018,15(11):860-864.DOI:10.3761/j.issn.1672-9234.2018.11.014.
[27] JEFFORD M,GOUGH K,DROSDOWSKY A,et al,A randomized controlled trial of a nurse-led supportive care package (survivor care) for survivors of colorectal cancer[J].The Oncologist,2016,21(8):1014-1023.DOI:10.1634/theoncologist.2015-0533.
[28] Al-MAZROU A M,SURADKAR K,MAURO C M,et al.Characterization of readmission by day of rehospitalization after colorectal surgery[J].Diseases of the Colon and Rectum,2017,60(2):202-212.DOI:10.1097/DCR.0000000000000734.
[29] HENSLEY B J,COONEY R N,HELLENTHAL N J,et al.Readmissions after colectomy:the upstate New York surgical quality initiative experience[J].Diseases of the Colon and Rectum,2016,59(5):419-425.DOI:10.1097/DCR.0000000000000566.
[30] PAQUETTE I M,SOLAN P,RAFFERTY J F,et al.Readmission for dehydration or renal failure after ileostomy creation[J].Diseases of the Colon and Rectum,2013,56(8):974-979.DOI:10.1097/DCR.0b013e31828d02ba.
[31] 杨婕,冯金华,李卡.结直肠癌患者术后1年内非计划性再入院影响因素分析[J].护士进修杂志,2015,30(6):551-552.DOI:10.16821/j.cnki.hsjx.2015.06.030.
[32] HENDREN S,MORRIS A M,ZHANG W,et al.Early discharge and hospital readmission after colectomy for cancer[J].Diseases of the Colon and Rectum,2011,54(11):1362-1367.DOI:10.1097/DCR.0b013e31822b72d3.
[33] DONAGHY E,SALISBURY L,LONE N I,et al.Unplanned early hospital readmission among critical care survivors:a mixed methods study of patients and carers[J].BMJ Quality and Safety,2018,27(11):915-927.DOI:10.1136/bmjqs-2017-007513.
[34] 李爽,孙丽娟,齐艳.同伴教育在结直肠癌造口患者健康教育中的研究进展[J].护理管理杂志,2017,17(9):644-646.DOI:10.3969/j.issn.1671-315X.2017.09.013.
[35] NAIK A D,HORSTMAN M J,LI L T,et al.User-centered design of discharge warnings tool for colorectal surgery patients[J].Journal of the American Medical Informatics Association,2017,24(5):975-980.DOI:10.1093/jamia/ocx018.
[36] 赵颖,闫荻,徐一丹.认知干预对结直肠癌患者癌因性疲乏与自我护理能力的影响[J].护理管理杂志,2014,14(4):284-285.
[37] LAFOREST A,BRETAGNOL F,MOUAZAN A S,et al.Functional disorders after rectal cancer resection:does a rehabilitation programme improve anal continence and quality of life?[J]Colorectal Disease,2012,14(10):1231-1237.DOI:10.1111/j.1463-1318.2012.02956.x.
[38] 何晓花,朱畅惠,高雪钦,等.造口护理信息管理系统开发及应用[J].护理管理杂志,2015,15(11):824-825.
[39] HARDIMAN K M,REAMES C D,MCLEOD M C,et al.Patient autonomy-centered self-care checklist reduces hospital readmissions after ileostomy creation[J].Surgery,2016,160(5):1302-1308.DOI:10.1016/j.surg.2016.05.007.
[40] 赵秋燕.浅析延续性护理干预对慢阻肺患者肺功能及生活质量的影响[J].中国卫生标准管理,2018,9(11):157-158.DOI:10.3969/j.issn.1674-9316.2018.11.083.
[41] 麻晶.结直肠癌合并糖尿病患者围手术期临床护理研究[J].糖尿病新世界,2016,19(22):157-158.DOI:10.16658/j.cnki.1672-4062.2016.22.157.
[42] SUTHERLAND T,DAVID-KASDAN J A,BELOFF J,et al.Patient and provider-identified factors contributing to surgical readmission after colorectal surgery[J].Journal of Investigative Surgery,2016,29(4):195-201.DOI:10.3109/08941939.2015.1124947.
[43] CHIU C F,LIN M I,LEE I,et al.Factors related to the unplanned 90-day readmission rate among elderly at a geriatric medicine center[J].Hu Li Za Zhi,2016,63(5):95-107.DOI:10.6224/JN.63.5.95.
[44] 吴晓丹,张丽娟,覃惠英,等.结直肠癌个案管理模式的实践及效果[J].护理管理杂志,2018,18(9):661-665.DOI:10.3969/j.issn.1671-315x.2018.09.013.
[45] 顾佳妮,周燕,王红萍.多学科合作协同护理模式对结肠造口患者造口自我护理能力和生活质量的影响[J].护理管理杂志,2018,18(1):72-75.DOI:10.3969/j.issn.1671-315x.2018.01.019.
[46] ALKAHALDI F,ALOUANI A.Systemic design approach to a real-time healthcare monitoring system:reducing unplanned hospital readmissions[J].Sensors(Basel),2018,18(8):2531.DOI:10.3390/s18082531.
[2] JUSTINIANO C,TEMPLE L,SWANGER A,et al.Readmissions with dehydration after ileostomy creation:rethinking risk factors[J].Diseases of the Colon and Rectum,2018,61(11):1297-1305.DOI:10.1097/DCR.0000000000001137.
[3] WEINBERG B A,MARSHALL J L,SALEM M E.The growing challenge of young adults with Ccolorectal cancer[J].Oncology(Williston Park),2017,31(5):381-389.
[4] CHEN W,ZHENG R,ZENG H,et al.The incidence and mortality of major cancers in China,2012[J].Chinese Journal of Cancer,2016,35(1):73.DOI:10.1186/s40880-016-0137-8.
[5] 邓丽娜,刘涛,张会君.老年结肠造口患者家属疾病不确定感及影响因素分析[J].中华护理杂志,2015,50(9):1047-1051.DOI:10.3761/j.issn.0254-1769.2015.09.004.
[6] JOYNT K E,JHA A K.A path forward on medicare readmissions[J].The New England Journal of Medicine,2013,368(13):1175-1177.DOI:10.1056/NEJMp1300122.
[7] DAMLE R N,ALAVI K.Risk factors for 30-d readmission after colorectal surgery:a systematic review[J].Journal of Surgical Research,2016,200(1):200-207.DOI:10.1016/j.jss.2015.06.052.
[8] SURI M F,QURESHI A I.Readmission within 1 month of discharge among patients with acute ischemic stroke:results of the University Health System Consortium Stroke Benchmarking study[J].Journal of Vascular and Interventional Neurology,2013,6(2):47-51.
[9] GREENBLATT D Y,WEBER S M,O'CONNOR E S,et al.Readmission after colectomy for cancer predicts one-year mortality[J].Annals of Surgery,2010,251(4):659-669.DOI:10.1097/SLA.0b013e3181d3d27c.
[10] WICK E C,SHORE A D,HIROSE K,et al.Readmission rates and cost following colorectal surgery[J].Diseases of the Colon and Rectum,2011,54(12):1475-1479.DOI:10.1097/DCR.0b013e31822ff8f0.
[11] LI L T,MILLS W L,WHITE D L,et al.Causes and prevalence of unplanned readmissions after colorectal surgery:a systematic review and meta-analysis[J].Journal of the American Geriatrics Society,2013,61(7):1175-1181.DOI:10.1111/jgs.12307.
[12] LOHSIRIWAT V.The influence of preoperative nutritional status on the outcomes of an enhanced recovery after surgery (ERAS) programme for colorectal cancer surgery[J].Techniques in Coloproctology,2014,18(11):1075-1080.DOI:10.1007/s10151-014-1210-4.
[13] LOOIJAARD S M L M,SLEE-VALENTIJN M S,OTTEN R H J,et al.Physical and nutritional prehabilitation in older patients with colorectal carcinoma:a systematic review[J].Journal of Geriatric Physical Therapy,2018,41 (4):236-244.DOI:10.1519/JPT.0000000000000125.
[14] SHARMA Y,MILLER M,KAAMBWA B,et al.Factors influencing early and late readmissions in Australian hospitalised patients and investigating role of admission nutrition status as a predictor of hospital readmissions:a cohort study[J].BMJ Open,2018,8(6):e022246.DOI:10.1136/bmjopen-2018-022246.
[15] GRANDA-CAMERON C,BEHTA M,HOVINGA M,et al.Risk factors associated with unplanned hospital readmissions in adults with cancer[J].Oncology Nursing Forum,2015,42(3):E257-E268.DOI:10.1188/15.ONF.E257-E268.
[16] DOUMOURAS A G,TSAO M W,SALEH F,et al.A population-based comparison of 30-day readmission after surgery for colon and rectal cancer:how are they different?[J].Journal of Surgical Oncology,2016,114(3):354-360.DOI:10.1002/jso.24334.
[17] HYDE L Z,AL-MAZROU A M,KURITZKES B A,et al.Readmissions after colorectal surgery:not all are equal[J].International Journal of Colorectal Disease,2018,33(12):1667-1674.DOI:10.1007/s00384-018-3150-3.
[18] POELEMEIJER Y Q M,LIJFTOGT N,DETERING R,et al.Obesity as a determinant of perioperative and postoperative outcome in patients following colorectal cancer surgery:a population-based study (2009-2016)[J].European Journal of Surgical Oncology,2018,44(12):1849-1857.DOI:10.1016/j.ejso.2018.05.027.
[19] CAAN B J,MEYERHARDT J A,KROENKE C H,et al.Explaining the obesity paradox:the association between body composition and colorectal cancer survival (C-SCANS Study)[J].Cancer Epidemiol Biomarkers Prevention,2017,26(7):1008-1015.DOI:10.1158/1055-9965.EPI-17-0200.
[20] ADAMOVá Z,BáR T.Influence of overweight and obesity on complications in colorectal surgery[J].Rozhledy Chirurgii Summer,2018,97(10):464-468.
[21] FRANCIS N K,MASON J,SALIB E,et al.Factors predicting 30-day readmission after laparoscopic colorectal cancer surgery within an enhanced recovery programme[J].Colorectal Disease,2015,17(7):148-154.DOI:10.1111/codi.13002.
[22] LAWSON E H,HALL B L,LOUIE R,et al.Association between occurrence of a postoperative complication and readmission:implications for quality improvement and cost savings[J].Annals of Surgery,2013,258(1):10-18.DOI:10.1097/SLA.0b013e31828e3ac3.
[23] SHAFFER R,BACKHUS L,FINNEGAN M A,et al.Thirty-day unplanned postoperative inpatient and emergency department visits following thoracotomy[J].The Journal of Surgical Research,2018,230:117-124.DOI:10.1016/j.jss.2018.04.065.
[24] YANG J,XIAO J,FENG J,et al.One-year unplanned readmission after colorectal cancer surgery in western China[J].Journal of Investigative Surgery,2018,31(17):1-5.DOI:10.1080/08941939.2018.1443176.
[25] RATTAN R,PARRECO J,LINDENMAIRE L B,et al.Underestimation of unplanned readmission after colorectal surgery:a national analysis[J].Journal of the American College of Surgeons,2018,226(4):382-390.DOI:10.1016/j.jamcollsurg.2017.12.012.
[26] 王志霞,徐惠丽,李静,等.急诊肠造口患者术后非计划性再入院现状及影响因素研究[J].中华护理教育,2018,15(11):860-864.DOI:10.3761/j.issn.1672-9234.2018.11.014.
[27] JEFFORD M,GOUGH K,DROSDOWSKY A,et al,A randomized controlled trial of a nurse-led supportive care package (survivor care) for survivors of colorectal cancer[J].The Oncologist,2016,21(8):1014-1023.DOI:10.1634/theoncologist.2015-0533.
[28] Al-MAZROU A M,SURADKAR K,MAURO C M,et al.Characterization of readmission by day of rehospitalization after colorectal surgery[J].Diseases of the Colon and Rectum,2017,60(2):202-212.DOI:10.1097/DCR.0000000000000734.
[29] HENSLEY B J,COONEY R N,HELLENTHAL N J,et al.Readmissions after colectomy:the upstate New York surgical quality initiative experience[J].Diseases of the Colon and Rectum,2016,59(5):419-425.DOI:10.1097/DCR.0000000000000566.
[30] PAQUETTE I M,SOLAN P,RAFFERTY J F,et al.Readmission for dehydration or renal failure after ileostomy creation[J].Diseases of the Colon and Rectum,2013,56(8):974-979.DOI:10.1097/DCR.0b013e31828d02ba.
[31] 杨婕,冯金华,李卡.结直肠癌患者术后1年内非计划性再入院影响因素分析[J].护士进修杂志,2015,30(6):551-552.DOI:10.16821/j.cnki.hsjx.2015.06.030.
[32] HENDREN S,MORRIS A M,ZHANG W,et al.Early discharge and hospital readmission after colectomy for cancer[J].Diseases of the Colon and Rectum,2011,54(11):1362-1367.DOI:10.1097/DCR.0b013e31822b72d3.
[33] DONAGHY E,SALISBURY L,LONE N I,et al.Unplanned early hospital readmission among critical care survivors:a mixed methods study of patients and carers[J].BMJ Quality and Safety,2018,27(11):915-927.DOI:10.1136/bmjqs-2017-007513.
[34] 李爽,孙丽娟,齐艳.同伴教育在结直肠癌造口患者健康教育中的研究进展[J].护理管理杂志,2017,17(9):644-646.DOI:10.3969/j.issn.1671-315X.2017.09.013.
[35] NAIK A D,HORSTMAN M J,LI L T,et al.User-centered design of discharge warnings tool for colorectal surgery patients[J].Journal of the American Medical Informatics Association,2017,24(5):975-980.DOI:10.1093/jamia/ocx018.
[36] 赵颖,闫荻,徐一丹.认知干预对结直肠癌患者癌因性疲乏与自我护理能力的影响[J].护理管理杂志,2014,14(4):284-285.
[37] LAFOREST A,BRETAGNOL F,MOUAZAN A S,et al.Functional disorders after rectal cancer resection:does a rehabilitation programme improve anal continence and quality of life?[J]Colorectal Disease,2012,14(10):1231-1237.DOI:10.1111/j.1463-1318.2012.02956.x.
[38] 何晓花,朱畅惠,高雪钦,等.造口护理信息管理系统开发及应用[J].护理管理杂志,2015,15(11):824-825.
[39] HARDIMAN K M,REAMES C D,MCLEOD M C,et al.Patient autonomy-centered self-care checklist reduces hospital readmissions after ileostomy creation[J].Surgery,2016,160(5):1302-1308.DOI:10.1016/j.surg.2016.05.007.
[40] 赵秋燕.浅析延续性护理干预对慢阻肺患者肺功能及生活质量的影响[J].中国卫生标准管理,2018,9(11):157-158.DOI:10.3969/j.issn.1674-9316.2018.11.083.
[41] 麻晶.结直肠癌合并糖尿病患者围手术期临床护理研究[J].糖尿病新世界,2016,19(22):157-158.DOI:10.16658/j.cnki.1672-4062.2016.22.157.
[42] SUTHERLAND T,DAVID-KASDAN J A,BELOFF J,et al.Patient and provider-identified factors contributing to surgical readmission after colorectal surgery[J].Journal of Investigative Surgery,2016,29(4):195-201.DOI:10.3109/08941939.2015.1124947.
[43] CHIU C F,LIN M I,LEE I,et al.Factors related to the unplanned 90-day readmission rate among elderly at a geriatric medicine center[J].Hu Li Za Zhi,2016,63(5):95-107.DOI:10.6224/JN.63.5.95.
[44] 吴晓丹,张丽娟,覃惠英,等.结直肠癌个案管理模式的实践及效果[J].护理管理杂志,2018,18(9):661-665.DOI:10.3969/j.issn.1671-315x.2018.09.013.
[45] 顾佳妮,周燕,王红萍.多学科合作协同护理模式对结肠造口患者造口自我护理能力和生活质量的影响[J].护理管理杂志,2018,18(1):72-75.DOI:10.3969/j.issn.1671-315x.2018.01.019.
[46] ALKAHALDI F,ALOUANI A.Systemic design approach to a real-time healthcare monitoring system:reducing unplanned hospital readmissions[J].Sensors(Basel),2018,18(8):2531.DOI:10.3390/s18082531.