1:45 PM, Abstract No. 271 - Complication and readmission rates following same day discharge after percutaneous renal tumor ablation

Abstract

There is variability in the post-percutaneous renal tumor ablation management with overnight admission being routine practice in many institutions. The aim of this study is to assess the clinical outcomes and readmission rates following same day discharge post CT-guided cryoablation and RFA of renal tumors. 173 consecutive renal tumor ablations for which same day discharge was planned, performed between 1/2004 and 1/2014, were retrospectively reviewed. The primary outcome was the rate of readmission within 30 days of same-day discharge. The secondary outcomes included the rate and clinical outcomes of periprocedural complications requiring admission. Perinephric hematoma, the most common complication, was evaluated by manual volume quantification from intraprocedural and follow-up cross sectional imaging and compared between admitted and discharged patients. 165 patients (95.4%) were discharged same-day with short-term readmission in 1 case (0.6%) for acute on chronic kidney injury. 8 patients (4.6%) who were planned to be discharged the same day, were admitted for complications related to ablation (Table 1). The majority of these complications were perinephric hematomas, with a mean volume of 272 mL (SE: 163) in those who were admitted versus 42 mL (SE: 15) in those who were discharged same day (P = 0.04). All instances were detected during the standard 4 hour observation period and all were managed conservatively without requiring surgery or renal artery embolization. No short-term readmissions occurred following discharge of admitted patients. Routine same day discharge following percutaneous renal tumor thermoablation can be performed with a low rate of short-term readmission and low rate of periprocedural complications. The majority of periprocedural complications can be managed conservatively and discharged same day.