MP16-20 PREDICTORS OF DISCHARGE TO HOME FOLLOWING MAJOR SURGERY FOR UROLOGIC MALIGNANCIES

Abstract

You have accessJournal of UrologyCME1 May 2022MP16-20 PREDICTORS OF DISCHARGE TO HOME FOLLOWING MAJOR SURGERY FOR UROLOGIC MALIGNANCIES Nehizena Aihie, Deukwoo Kwon, Matthew Mason, Helen Yang Hougen, Dimple Chananmolu, Sanoj Punnen, Bruno Nahar, Dipen Parekh, Mark Gonzalgo, and Chad Ritch Nehizena AihieNehizena Aihie More articles by this author , Deukwoo KwonDeukwoo Kwon More articles by this author , Matthew MasonMatthew Mason More articles by this author , Helen Yang HougenHelen Yang Hougen More articles by this author , Dimple ChananmoluDimple Chananmolu More articles by this author , Sanoj PunnenSanoj Punnen More articles by this author , Bruno NaharBruno Nahar More articles by this author , Dipen ParekhDipen Parekh More articles by this author , Mark GonzalgoMark Gonzalgo More articles by this author , and Chad RitchChad Ritch More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002549.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Discharge to home is a measurable patient outcome used to assess quality of care for hospitals. The 2021 US news and world report (USNWR) uses this metric to rate patient outcomes when calculating Urology hospital rankings. Our objective was to identify patient risk factors that predict non-home discharge after surgery for urologic malignancies. METHODS: The ACS-NSQIP database was queried using urology specific Current Procedural Terminology (CPT) codes to retrospectively identify patients who had undergone open, laparoscopic, or robotic surgery for urologic malignancies including prostate, bladder, kidney, or upper tract urothelial cancer from 2011-2019. Descriptive statistics were used to compare patients who were discharged to home versus non-home discharges. Univariable and multivariable logistic regression analysis were performed to identify patient characteristics that were associated with non-home discharges. All tests were two-sided and statistical significance was considered when p<0.05. RESULTS: Non-home discharge occurred in 3.03% of the 103,244 patients in our study. In our study population 91.7% were male while 8.3% were female. Women were more likely to have non-home discharges (male:female OR 0.62 p<0.0001). As expected, non-home discharge was more common in patients who underwent cystectomy when compared to nephrectomy (OR 1.51 p=0.016) or prostatectomy (OR 1.56 p=0.002). Those with elevated BMI were less likely to experience non-home discharge (OR 0.85 p=0.002) while patients who were identified as underweight and those with unexpected weight loss prior to surgery were more likely to have non-home discharges (OR 1.90 p<0.0001, OR 2.02, p<0.0001). Comorbidities including diabetes and cardiopulmonary disease were also found to be significant independent predictors of non-home discharges. CONCLUSIONS: Patient factors including age, gender, weight, comorbidities, and site of procedure were found to be independent predictors of non-home discharge following surgery for urologic malignancies. Patients with these risk factors should be counseled pre-operatively on the likelihood of requiring a non-home discharge to help manage expectations and create a standardized transition of care pathway following surgery. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e283 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nehizena Aihie More articles by this author Deukwoo Kwon More articles by this author Matthew Mason More articles by this author Helen Yang Hougen More articles by this author Dimple Chananmolu More articles by this author Sanoj Punnen More articles by this author Bruno Nahar More articles by this author Dipen Parekh More articles by this author Mark Gonzalgo More articles by this author Chad Ritch More articles by this author Expand All Advertisement PDF DownloadLoading ...