MP22-15 POPULATION-BASED ASSESSMENT OF DETERMINING PREDICTORS FOR DISCHARGE DISPOSITION IN PATIENTS WITH BLADDER CANCER UNDERGOING RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP22-15 POPULATION-BASED ASSESSMENT OF DETERMINING PREDICTORS FOR DISCHARGE DISPOSITION IN PATIENTS WITH BLADDER CANCER UNDERGOING RADICAL CYSTECTOMY Raj Kumar, Kian Asanad, Luis Medina, Gus Miranda, Jie Cai, Hooman Djalat, Mihir Desai, Inderbir Gill, Saum Ghodoussipour, and Giovanni Cacciamani Raj KumarRaj Kumar More articles by this author , Kian AsanadKian Asanad More articles by this author , Luis MedinaLuis Medina More articles by this author , Gus MirandaGus Miranda More articles by this author , Jie CaiJie Cai More articles by this author , Hooman DjalatHooman Djalat More articles by this author , Mihir DesaiMihir Desai More articles by this author , Inderbir GillInderbir Gill More articles by this author , Saum GhodoussipourSaum Ghodoussipour More articles by this author , and Giovanni CacciamaniGiovanni Cacciamani More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003247.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical cystectomy (RC) remains the mainstay of treatment for muscle-invasive bladder cancer. Discharge disposition (DD) following RC - either home or to a continued rehabilitation facility (CRF) – is a clinical decision based on several clinical measures. Given that DD can have a dramatic impact on patient expense and recovery, the purpose of this study is to assess predictors of DD after undergoing RC for bladder cancer in the United States. METHODS: This study is a retrospective, cohort study. Patients were divided into two cohorts: those discharged home and those discharged to CRF. We examined patient, surgical, and hospital characteristics. Multivariable logistic regression models were used to control for selected variables. All statistical tests were two-sided. Patients were derived from the Premier Healthcare Database. International classification of disease (ICD)-9 (<2014), ICD-10 (≥ 2015), and Current Procedural Terminology (CPT) codes were used to identify patient diagnoses and encounters. The population consisted of 138,151 patients who underwent RC for bladder cancer between January 1, 2000 and December 31, 2019. RESULTS: A total of 24,922 (18.0%) of patients were admitted to CRFs. Multivariate analysis revealed that older age [Odds Ratio (OR):1.066, 95% Confidence Interval (CI): 1.063-1.068], single/widowed marital status [OR:2.232, 95%CI:2.160-2.307], female gender [OR:1.444, 95%CI:1.392-1.497], increased Charlson Comorbidity Index (CCI) [CCI=1 OR:1.285, 95%CI:1.162-1.421] [CCI≥2 OR:2.123, 95%CI:1.976-2.281], Medicaid [OR:1.949, 95%CI:1.785-2.129], and Medicare insurance [OR:1.870, 95%CI:1.774-2.129] are associated with CRF discharge. Rural hospital location [OR:0.873, 95%CI:0.824-0.925], self-pay status [OR:0.710, 95%CI:0.565-0.891], increased annual surgeon case [OR:0.660, 95%CI:0.624-0.697], and robotic surgical approach [OR:0.777, 95%CI:0.744-0.811] are associated with home discharge. CONCLUSIONS: Several specific patient, surgical, and facility characteristics were identified that may significantly impact DD after RC for bladder cancer. This new information should help with preoperative counseling and shared decision-making. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e302 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Raj Kumar More articles by this author Kian Asanad More articles by this author Luis Medina More articles by this author Gus Miranda More articles by this author Jie Cai More articles by this author Hooman Djalat More articles by this author Mihir Desai More articles by this author Inderbir Gill More articles by this author Saum Ghodoussipour More articles by this author Giovanni Cacciamani More articles by this author Expand All Advertisement PDF downloadLoading ...