928 Risk factors of hospital readmissions following open radical cystectomy and urinary diversion: Analysis of 1000 consecutive patients

Abstract

INTRODUCTION AND OBJECTIVES: To analyze risk factors predicting complications requiring hospital readmissions in a large cohort of patients undergoing open radical cystectomy and urinary diversion. METHODS: We retrospectively analyzed our prospective database for 1000 consecutive patients who underwent open radical cystectomy and urinary diversion between January 2004 and September 2009. Patients’ demographics, perioperative data and postoperative complications were categorized and analyzed. Primary outcome of the study is the development of complications requiring readmission to the hospital. Readmissions were classified as early if occurring within first 3 months of hospital discharge while late as 3 months thereafter. Univariable and multivariable analyses were performed to detect factors predicting the primary outcome of the study. RESULTS: Out of 1000 patients, 172 (17.2%) were readmitted including 78 (7.8%) early readmissions and 94 (9.4%) late readmissions. The main causes of early readmissions were pyelonephritis, ureteral obstruction, metabolic acidosis and intestinal obstruction in 17 (21.8%), 14 (17.9%) and 11 (14.1%), and 7 (9%), respectively. The main causes of late readmissions included ureteral obstruction, intestinal obstruction, metabolic acidosis and pouch stones in 16 (17%), 15 (16%), 8 (8.5%) and 8 (8.5), respectively. Cox regression analysis revealed continent urinary diversion was an independent predictor of complications requiring hospital readmission (HR: 1.67; 95%CI: 1.22.4; p 0.005). CONCLUSIONS: Hospital readmission rate after radical cystectomy is considerably high with continent urinary diversion.