肝移植患者非计划性再入院发生率及影响因素的Meta分析  

Meta-analysis of the Incidence and Influencing Factors of Unplanned Readmission in Patients Undergoing Liver Transplantation

作　　者：贺田 沈鸣雁 方丹 贾欣宇 朱荣昌 HE Tian;SHEN Mingyan;FANG Dan;JIA Xinyu;ZHU Rongchang(Zhejiang Shuren University,Hangzhou 310000,Zhejiang,China;School of Nursing,Nanjing University of Chinese Medicine,Nanjing 210000,Jiangsu,China)

机构地区：[1]浙江树人学院,浙江杭州310000 [2]南京中医药大学护理学院,江苏南京210000

出　　处：《医学信息》2025年第4期29-36,共8页Journal of Medical Information

基　　金：2024年度浙江省中医药科技计划(编号:2024ZL845)。

摘　　要：目的探讨肝移植患者非计划性再入院的发生率及影响因素,为早期识别患者再入院提供依据。方法计算机检索PubMed、Web of Science、Embase、The Cochrane Library、中国知网、万方、中国生物医学文献数据库、维普数据库发表的相关文献,检索时间均从建库至2023年9月23日。由两名研究者独立筛选文献、提取资料、对文献进行偏倚风险质量评价,采用Stata16软件进行Meta分析。结果共纳入18篇文献,文献整体质量中等偏高,总样本量45320例。肝移植患者非计划性再入院的发生率范围为10%~64%,合并发生率为38%(95%CI:0.34~0.43)。受者年龄[OR=1.04,95%CI(1.02,1.07),P<0.001]、感染[OR=1.32,95%CI(0.87,2.01),P=0.003]、合并糖尿病[OR=2.54,95%CI(1.46,4.42),P=0.001]、移植前透析[OR=1.83,95%CI(1.23,2.72),P=0.003]、移植指证(肝病病因)[OR=2.22,95%CI(1.68,2.92),P<0.001]、器官捐赠类型[OR=1.23,95%CI(1.01,1.50),P=0.036]、术后并发症[OR=1.34,95%CI(1.01,1.67),P=0.017]是肝移植患者非计划性再入院的危险因素,男性[OR=0.60,95%CI(0.44,0.83),P=0.002]、使用降低再入院方案[OR=0.34,95%CI(0.23,0.53),P<0.001]、周末出院[OR=0.41,95%CI(0.25,0.66),P<0.001]是肝移植患者非计划性再入院的保护因素。结论受者年龄、感染、合并糖尿病、移植前透析、移植指征(肝病病因)、器官捐献类型、术后并发症、男性、使用降低再入院方案、周末出院与肝移植患者非计划性再入院密切相关。但本研究纳入文献为观察性研究,存在一定局限性,尚需开展更多大样本的前瞻性队列研究来进行验证。Objective To investigate the incidence and influencing factors of unplanned readmission in patients undergoing liver transplantation,and to provide evidence for early identification of readmission.Methods The relevant literatures published in PubMed,Web of Science,EMbase,The Cochrane Library,CNKI,Wanfang,Chinese Biomedical Literature Database and VIP Database were searched by computer.The retrieval time was from the establishment of the database to September 23,2023.Two researchers independently screened the literature,extracted the data,and evaluated the quality of bias risk of the literature.Meta-analysis was performed using Stata16 software.Results A total of 18 articles were included,and the overall quality of the literature was moderately high,with a total sample size of 45320 cases.The incidence of unplanned readmission in patients with liver transplantation ranged from 10%to 64%,and the combined incidence was 38%(95%CI:0.34-0.43).Recipient age[OR=1.04,95%CI(1.02,1.07),P<0.001],infection[OR=1.32,95%CI(0.87,2.01),P=0.003],diabetes mellitus[OR=2.54,95%CI(1.46,4.42),P=0.001],dialysis before transplantation[OR=1.83,95%CI(1.23,2.72),P=0.003],transplantation indication(etiology of liver disease)[OR=2.22,95%CI(1.68,2.92),P<0.001],organ donation type[OR=1.23,95%CI(1.01,1.50),P=0.036],postoperative complications[OR=1.34,95%CI(1.01,1.67),P=0.017]were risk factors for unplanned readmission in patients with liver transplantation.Male[OR=0.60,95%CI(0.44,0.83),P=0.002],use of reduced readmission regimen[OR=0.34,95%CI(0.23,0.53).P<0.001]and discharge at weekends[OR=0.41,95%CI(0.25,0.66),P<0.001]were protective factors for unplanned readmission in liver transplant patients.Conclusion Recipient age,infection,diabetes mellitus,dialysis before transplantation,transplantation indication(etiology of liver disease),type of organ donation,postoperative complications,male,use of reduced readmission program,and discharge at weekends are closely related to unplanned readmission of liver transplant patients.However,the literature inc

关 键 词：肝移植 非计划性再入院 影响因素 病例对照研究 队列研究 META分析 

分 类 号：R617[医药卫生—外科学]