Ce travail a été l’objet d’une publication parue en juin 2017 dans European Urology Focus référencée sur PubMed :
Manach Q, Rouprêt M, Reboul-Marty J, Drouin S.J, Guillot-Tantay C, Matillon X, Parra J, Mozer P, Bitker M-O, Lefèvre J.H, Phé V. Hospital readmissions after urological surgical procedures in France: a nationwide cohort study over three years. Eu Urol Focus. Jun 2017.
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RÉSUMÉ
Objectif :
L’objectif était d’évaluer le taux de réadmission chirurgicale après une procédure urologique et d’identifier les facteurs de risque associés à une réadmission.
Matériel et méthodes :
Les données de toutes les hospitalisations concernant les chirurgies urologiques planifiées entre janvier 2010 et novembre 2012 ont été extraites du Programme de Médicalisation des Systèmes d'Information. Le taux de réadmission était évalué à partir des ré-hospitalisations réalisées dans les 30 jours suivant la chirurgie urologique. Les facteurs de risque suivants ont été évalués : le sexe, l’âge, le Groupe Homogène de Malades (GHM), la durée de l'hospitalisation initiale, le type d'hospitalisation (conventionnelle ou ambulatoire), le volume d’activité de chirurgie urologique global de l’établissement ainsi que le volume d’activité spécifique de la procédure réalisée et le statut administratif de l’établissement. Une analyse multivariée par régression logistique a été utilisée pour évaluer les facteurs de risque.
Résultats :
Au total, 419 787 patients ont été inclus, dont 77 241 patients (18,40%) ont été réadmis dans les 30 jours suivant l’intervention. Après analyses multivariées, le sexe masculin (OR = 1,84 [CI95% : 1,81-1,88]), un GHM élevé (GHM 3-4 vs. 1-2 : OR = 2,14 [CI95% : 2,10-2,21]) et la prise en charge initiale dans un établissement privé (Hôpital privé vs. Hôpital universitaire : OR = 1,13 [IC95% : 1,11-1,16], Hôpital privé vs. Hôpital public : OR = 1,21 [CI95% : 1,18- 1,23]) ont été associés à un risque plus élevé de réadmission dans les 30 jours.
Conclusion :
Le taux de réadmission dans les 30 jours suivant une procédure urologique planifiée était de 20%.
MOTS CLÉS
Réadmission ; Procédure chirurgicale urologique ; Volume d’activité chirurgicale ; Durée de séjour ; Statut administratif ; Groupe Homogène de Malades.