MP24-20 CAUSES OF HOSPITAL READMISSIONS AFTER UROLOGIC CANCER SURGERY

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness III1 Apr 2015MP24-20 CAUSES OF HOSPITAL READMISSIONS AFTER UROLOGIC CANCER SURGERY Marianne Schmid, Abraham Chiang, Akshay Sood, Logan Campbell, Felix Chun, Deepansh Dalela, James Okwara, Jesse Sammon, Adam Kibel, Mani Menon, Margit Fisch, and Quoc-Dien Trinh Marianne SchmidMarianne Schmid More articles by this author , Abraham ChiangAbraham Chiang More articles by this author , Akshay SoodAkshay Sood More articles by this author , Logan CampbellLogan Campbell More articles by this author , Felix ChunFelix Chun More articles by this author , Deepansh DalelaDeepansh Dalela More articles by this author , James OkwaraJames Okwara More articles by this author , Jesse SammonJesse Sammon More articles by this author , Adam KibelAdam Kibel More articles by this author , Mani MenonMani Menon More articles by this author , Margit FischMargit Fisch More articles by this author , and Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1162AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The Hospital Readmissions Reduction Program mandates reimbursement reductions to hospitals with higher than expected rates of readmissions. We examine causes and predictors of readmissions following major procedures in urologic oncology. METHODS Using the American College of Surgeons National Surgical Quality Improvement Program database, patients undergoing radical prostatectomy (RP), radical (RN) or partial nephrectomy (PN), and radical cystectomy (RC) during the year 2012 were abstracted. Rates of unplanned readmission within 30 days after surgery, as well as causes of readmission, were identified. Multivariable logistic regression models were fitted to examine the association between patient perioperative factors and odds of readmission. RESULTS 0-day readmission rates for patients treated with RP, RN, PN and RC were 4.1, 5.2, 4.5 and 15.9%, respectively. Commonest causes of readmission after RP included thromboembolic (13.6%), wound (12.2%), renal/genitourinary (12.2%), and gastrointestinal (11.8%), after RN wound (12.9%) and gastrointestinal (12.9%), after PN renal/genitourinary (19.6%), cardiovascular (9.8%) and bleeding/hematoma (9.8%) and after RC renal/genitourinary (15.5%), wound (14.8%) and sepsis/infection (14.1%). Patients undergoing open RP or PN, were more likely to be readmitted relative to their minimally invasive counterparts (OR: 1.53, 95% CI: 1.12-2.08, p=0.007 and OR: 2.51, 95% CI: 1.38-4.55, p=0.003, respectively). CONCLUSIONS Readmissions are relatively common following major urologic oncology procedures. Venous thromboembolism is a common modifiable cause of readmission following urologic cancer surgery. RC patients experience a rapid increase in readmission rates following discharge and experience a high burden of readmission. Minimally invasive approach is associated with decreased odds of readmission following RP and PN. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e284 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marianne Schmid More articles by this author Abraham Chiang More articles by this author Akshay Sood More articles by this author Logan Campbell More articles by this author Felix Chun More articles by this author Deepansh Dalela More articles by this author James Okwara More articles by this author Jesse Sammon More articles by this author Adam Kibel More articles by this author Mani Menon More articles by this author Margit Fisch More articles by this author Quoc-Dien Trinh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...