摘要
目的 构建加速康复外科（ERAS）模式下结直肠癌患者术后1年内非计划性再入院的风险评估工具.方法 采用目的抽样法选择2010年1月—2013年5月四川大学华西医院胃肠外科中心收治并完成1年随访的446例患者.采用Logistic回归分析ERAS模式下结直肠癌患者非计划再入院的影响因素.通过文献查阅及回顾性病例对照研究拟定ERAS模式下结直肠癌患者术后1年非计划性再入院的风险评估指标,采用德尔菲专家咨询法进行指标筛选及权重赋值.结果 Logistic回归分析结果显示首次住院术前合并症个数为ERAS模式下结直肠癌患者非计划再入院的影响因素（OR=2.91）.两轮专家咨询回收率均为100%,专家权威系数为0.91,专家协调系数为0.361（χ2=32.711,P〈0.001）.经过两轮专家咨询,共筛选出4项风险评估指标：术前合并症、通过急诊入院、高龄、术后异常情况.结论 通过德尔菲法构建的ERAS模式下结直肠癌患者术后1年非计划性再入院风险评估工具有较高的可靠性,可用于ERAS模式下结直肠癌患者再入院凤险评估,但需进一步验证其临床适用性.
Objective To construct a risk assessment tool of unplanned readmission within 1 year after colorectal cancer surgery in patients under enhanced recovery after surgery （ERAS） mode. Methods A total of 446 patients who were treated in Gastrointestinal Surgery Department of West China Hospital and had been followed up for one year from January 2010 to May 2013 were selected as the research subjects by purposive sampling method. Logistic regression was adopted to analyze the influencing factors of unplanned readmission in colorectal cancer patients under ERAS. Through literature review and retrospective case control study, the risk assessment index of unplanned readmission for 1 year after colorectal cancer surgery in ERAS mode was drawn up, and the index selection and weight assignment were carried out by Delphi expert consultation method. Results The result of Logistic regression analysis showed that complications before first admission was the influencing factor of unplanned readmission in colorectal patients under ERAS（OR=2.91）. The recovery rates of the two rounds of expert consultation were 100%, the expert authority coefficient was 0.91, and the expert consultation coordination coefficient was 0.361 （χ2=32.711, P〈0.001）. Four items of risk assessment indexes were established after two rounds of expert consultation, including： complications before surgery, emergency admission, advanced age and postoperative abnormalities. Conclusions The risk assessment tool for unplanned readmission within one year after colorectal cancer surgery in patients under ERAS mode was constructed with high reliability. It can be used to assess the unplanned readmission risk of patients with colorectal cancer, but its clinical applicability needs to be further verified.
出处
《中华现代护理杂志》
2018年第2期143-146,共4页
Chinese Journal of Modern Nursing
基金
CMB护理青年教师科研基金项目（13-168-201405）
关键词
结直肠肿瘤
加速康复外科
非计划再入院
风险评估
德尔菲法
Colorectal neoplasms
Enhanced recovery after surgery
Unplanned readmission
Risk assessment
Delphi method
