MP19-09 INTERACTIVE HOME MONITORING AFTER RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP19-09 INTERACTIVE HOME MONITORING AFTER RADICAL CYSTECTOMY Emmett H. Kennady, Thi Nguyen, Joseph Caruso, Terran Sims, Fionna Sun, Karie Wilson, Novella Thompson, Eva Rellins, Stephen H. Culp, Christine Ibilibor, Sumit Isharwal, Tracey L. Krupski, and Kirsten L. Greene Emmett H. KennadyEmmett H. Kennady More articles by this author , Thi NguyenThi Nguyen More articles by this author , Joseph CarusoJoseph Caruso More articles by this author , Terran SimsTerran Sims More articles by this author , Fionna SunFionna Sun More articles by this author , Karie WilsonKarie Wilson More articles by this author , Novella ThompsonNovella Thompson More articles by this author , Eva RellinsEva Rellins More articles by this author , Stephen H. CulpStephen H. Culp More articles by this author , Christine IbiliborChristine Ibilibor More articles by this author , Sumit IsharwalSumit Isharwal More articles by this author , Tracey L. KrupskiTracey L. Krupski More articles by this author , and Kirsten L. GreeneKirsten L. Greene More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003244.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Interactive home monitoring (IHM) is a comprehensive transition program designed to dynamically monitor and deliver post-surgical needs at home. This program not only assesses vitals and sends them directly into the electronic medical record but also combats barriers to healthcare and functions as an advocate for clinical follow-up. Use of IHM in radical cystectomy, a surgery with high risk of complications and re-admissions, has not been evaluated. This study assesses outcomes of radical cystectomy patients enrolled in IHM and compares results to a control group. METHODS: Retrospective data was evaluated on all patients receiving radical cystectomy from September 2020 to June 2022. Primary outcomes are 90- and 30-day re-admissions and mortality. We defined cohorts based on IHM status and comparison tested was performed using chi-squared, Fisher’s exact, and student’s t-test. Multivariate linear regression was performed on combined cohorts to identify variables associated with outcomes. RESULTS: A total of 80 patients were evaluated during the study period. Table 1 contains patient demographics. There were no differences in baseline characteristics between the IHM and control groups in age, gender, BMI, smoking status, surgical technique, diversion type, or adjuvant therapy. Charleston comorbidity index (p=0.006) and enhanced recovery after surgery protocol (ERAS) (p=0.011) differed between cohorts. When dichotomized by T2 or less vs greater than T2, the IHM group had higher cancer stage (p=0.004). The IHM group had 35% of patients with a 90 day re-admission and 30% with a 30 day re-admission. The control group had 47.5% of patients with a 90 day re-admission and 40% with a 30 day re-admission. Combination of cohorts showed ERAS to be a predictor of 90- (OR=0.10; p<0.001) and 30-day (OR=0.14; p<0.001) readmission on multivariate analysis. The IHM group had 0 (0%) deceased patients and the control group had 2 (5%) deceased patients 90 days following surgery. CONCLUSIONS: Although the IHM group had significantly more comorbidities and greater disease burden, the IHM group had a lower 35% 90-day readmissions relative to the control group’s 47.5% readmissions. This novel method of post-discharge continuity of care is appealing in the potential to discharge highly comorbid patients to their homes and decrease re-admission and mortality rates. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e268 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emmett H. Kennady More articles by this author Thi Nguyen More articles by this author Joseph Caruso More articles by this author Terran Sims More articles by this author Fionna Sun More articles by this author Karie Wilson More articles by this author Novella Thompson More articles by this author Eva Rellins More articles by this author Stephen H. Culp More articles by this author Christine Ibilibor More articles by this author Sumit Isharwal More articles by this author Tracey L. Krupski More articles by this author Kirsten L. Greene More articles by this author Expand All Advertisement PDF downloadLoading ...