科研之友
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摘要
Objective: The purpose of this study was to comprehensively analyze the unplanned reoperations in neurosurgery within our center and to explore potential factors associated with unplanned reoperations. Methods: The authors retrospectively reviewed the patients who underwent unplanned reoperations in the Department of Neurosurgery of West China Hospital of Sichuan University from May 2015 to October 2016. The patients' basic characteristics, perioperative data of the initial surgeries and reoperations, outcomes, length of stay (LOS) and hospitalization expenses were collected for analysis. Factors associated with unplanned reoperations were identified using univariate analysis and multivariate logistic regression modeling. Results: A total of 115 patients and 129 unplanned reoperations were included. The overall incidence of unplanned reoperations was 1.37%. The principal diseases were tumors (50.4%), aneurysms (18.3%) and vascular malformations (11.3%). The most common causes of unplanned reoperations were postoperative hemorrhage (42.6%) and postoperative hydrocephalus (25.6%). Higher age and supratentorial location were risk factors for postoperative hemorrhage. Risk factors for postoperative hydrocephalus included younger age, infratentorial location, leukocytosis and rotation of first-line doctors. Patients who underwent unplanned reoperations had poorer outcomes, longer LOS and higher hospitalization expenses. Conclusions: Identifying patients at a higher risk for unplanned reoperations may improve the quality of surgical care More studies are warranted to explore the risk factors for unplanned reoperations. We recommended standard report and regular discussion on the reoperated cases. Besides, it is urgent to perform systematic root-cause analyses and to establish perioperative protocols through multidisciplinary work to reduce the frequency of unplanned reoperations.
- 出版日期2018
- 单位四川大学
