MP12-20 PREDICTORS OF 30-DAY COMPLICATIONS AND HOSPITAL READMISSIONS FOLLOWING ADRENALECTOMY.

Abstract

INTRODUCTION AND OBJECTIVES: Minimally invasive adrenalectomy (laparoscopic and robot-assisted) may offer lower postoperative morbidity and mortality. The purpose of this study is to analyze postoperative complications, readmission rates, and predictors of readmission in minimally invasive adrenalectomy (MIA) using a national outcomes database. METHODS: American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database was used to analyze patients who underwent MIA in 2011 and 2012. Perioperative variables and Clavien complications were analyzed using multivariate regression analysis. P<0.05 was considered statistically significant. RESULTS: Of the total (N 1⁄4 1,294) patients that were included in the analysis, N1⁄41,093 (84%) were performed via MIA, N1⁄4555 (43%) were male, and N1⁄4124 (10%) were performed by urologists. A total of N1⁄4138 (10.6%) patients had at least one complication. Complications based on Clavien were as follows: Clavien I N1⁄418 (13%); Clavien II N1⁄475 (54.3%); Clavien III N1⁄414 (10.1%); Clavien IV N1⁄428 (20.2); and Clavien V N1⁄43 (2.2%). On multivariate analysis, predictors for Clavien III-V included higher ASA score (p1⁄40.01), open surgical approach (p1⁄40.02), and lower preoperative albumin level (p1⁄40.01). Readmission rates within 30-days because of a complication remain low (N1⁄477, 6%). On multivariate analysis, predictors for readmission included higher ASA score (p1⁄40.02), and history of diabetes mellitus (p1⁄40.03). CONCLUSIONS: Minimally invasive adrenalectomy complications rates and readmission rates are low, and but can have high Clavien grade (Clavien III-V) when they happen. Predictors for highgrade Clavien complications include higher ASA score, open surgical approach, and lower preoperative albumin. Predictors for readmission included higher ASA score, and history of diabetes mellitus.