55 READMISSION FOLLOWING ROBOT-ASSISTED RADICAL CYSTECTOMY: OUTCOMES & PREDICTORS AT 90-DAYS

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-Based Medicine & Outcomes (I)1 Apr 201355 READMISSION FOLLOWING ROBOT-ASSISTED RADICAL CYSTECTOMY: OUTCOMES & PREDICTORS AT 90-DAYS Ali AL-Daghmin, Rakeeba Din, Aabroo khan, Ahmed Aboumohamed, Jenna Sztorc, Diana Mehedint, Mohamad Sharif, Yi Shi, Gregory Wilding, and Khurshid A. Guru Ali AL-DaghminAli AL-Daghmin Buffalo, NY More articles by this author , Rakeeba DinRakeeba Din Buffalo, NY More articles by this author , Aabroo khanAabroo khan Buffalo, NY More articles by this author , Ahmed AboumohamedAhmed Aboumohamed Buffalo, NY More articles by this author , Jenna SztorcJenna Sztorc Buffalo, NY More articles by this author , Diana MehedintDiana Mehedint Buffalo, NY More articles by this author , Mohamad SharifMohamad Sharif Buffalo, NY More articles by this author , Yi ShiYi Shi Buffalo, NY More articles by this author , Gregory WildingGregory Wilding Buffalo, NY More articles by this author , and Khurshid A. GuruKhurshid A. Guru Buffalo, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1431AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite advances in minimally invasive approaches to radical cystectomy significant morbidity remains unchanged. We sought to characterize the outcomes and predictors of readmission after RARC during early (30-day) and late (31-90- day) postoperative period. METHODS We retrospectively evaluated our prospectively maintained robot-assisted radical cystectomy (RARC) quality assurance database of 272 consecutive patients operated between 2005 and 2012. We evaluated all peri-operative outcomes and their relationship with readmission and examined for possible predictors during early and late postoperative periods. RESULTS Overall 30 & 90-day mortality was 0.7 and 4.8% respectively. 25.5% patients were readmitted within 90 days following RARC (61%-early; ≤30-day readmission and 39% late; 30-90 day readmission). Infection-related issues were the most common causes of readmission in both early & late periods. Overall operative time and obesity were significantly associated with readmission (p-value=0.034 and 0.033, respectively); meanwhile body mass index (BMI) and female gender were independent predictors of 90-day readmission (p-value=0.004 and 0.014, respectively). Getting any type of complications statistically correlated with 90-day readmission (p-value=0.0045), meanwhile when complications were graded based on Clavien grading system, grade 1-2 statistically correlated with readmission (p-value=0.046), while higher grade complications did not. 4 patients needed reoperation (2 patients in the early “for appendicitis and adhesive small bowel obstruction” and 2 in the late “for uretero-enteric stricture” readmission), meanwhile, 6 patients needed percutaneous procedures (4 patients in the early “1 for anastomotic leak and 3 for pelvic collections”, and 2 “for pelvic collections and uretero-cutaneous fistula” in the late readmission). CONCLUSIONS Rate of readmission within 90 days after RARC is significant. Female gender and BMI were found to be independent predictors of readmission. Reporting of outcomes at 90-days helps report thorough outcomes, which benefit in proper counseling of patients undergoing radical cystectomy. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e22 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ali AL-Daghmin Buffalo, NY More articles by this author Rakeeba Din Buffalo, NY More articles by this author Aabroo khan Buffalo, NY More articles by this author Ahmed Aboumohamed Buffalo, NY More articles by this author Jenna Sztorc Buffalo, NY More articles by this author Diana Mehedint Buffalo, NY More articles by this author Mohamad Sharif Buffalo, NY More articles by this author Yi Shi Buffalo, NY More articles by this author Gregory Wilding Buffalo, NY More articles by this author Khurshid A. Guru Buffalo, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...