MP32-02 RADICAL PROSTATECTOMY READMISSIONS: CAUSES, RISK FACTORS, NATIONAL RATES, & COSTS

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History II (MP32)1 Sep 2021MP32-02 RADICAL PROSTATECTOMY READMISSIONS: CAUSES, RISK FACTORS, NATIONAL RATES, & COSTS Shiva Balasubramanian, Xi Wang, An-Lin Cheng, Jignesh H. Shah, and William P. Parker Shiva BalasubramanianShiva Balasubramanian More articles by this author , Xi WangXi Wang More articles by this author , An-Lin ChengAn-Lin Cheng More articles by this author , Jignesh H. ShahJignesh H. Shah More articles by this author , and William P. ParkerWilliam P. Parker More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002036.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Readmissions have substantial clinical and financial impacts on the healthcare system. Radical prostatectomy (RP) is considered a standard treatment in the management of clinically localized prostate cancer. Yet there is a paucity of research evaluating readmissions for RP in a national dataset. We sought to evaluate 30-day and 90-day readmission rates and risk factors for RP using the 2018 Nationwide Readmissions Database (NRD) – a longitudinal database that represents over 58% of all US hospitalizations. METHODS: Using the NRD, patients with histologically confirmed prostate cancer managed with radical prostatectomy were identified and clinicopathologic data were abstracted for patients and facilities. The primary end-point was 30-day and 90-day readmissions. Patient and facility factors were assessed for associations with readmission using univariable and multivariable analyses. RESULTS: Between January and September 2018, a total of 33,351 patients were identified. Readmission rates for 30 and 90 days were 5.1% and 7.0% respectively. The most common cause of readmission at both timepoints was complication (12.59% and 12.78% respectively) followed by septicemia (12.2% and 10.76% respectively). The most frequent procedure performed during both 30 and 90 day readmission hospitalizations was abdominal drainage (18.38% and 19.03% respectively). Mean index cost for RP was $15,602. On multivariable logistic regression, factors associated with both 30 and 90 day readmission include nonroutine discharge (30 Day: OR 1.96, 95% CI 1.642, 2.34; 90 Day: OR 2.066, 95% CI 1.748, 2.441), lymphadenectomy (30 Day: OR 1.203, 95% CI 1.006, 1.439; 90 Day: OR 1.215, 95% CI 1.057, 1.399), index admission cost > 75th Percentile (30 Day: OR 1.335, 95% CI 1.138, 1.567; 90 Day: OR 1.287, 95% CI 1.120, 1.479), and index admission length of stay > 75th Percentile (30 Day: OR 1.536, 95% CI 1.319, 1.789; 90 Day: OR 1.464, 95% CI 1.290, 1.661). CONCLUSIONS: Our findings regarding predictors of readmission provide insight for preoperative counseling of patients receiving RP. Additionally, the results of this study may impact postoperative care guidelines. Elucidation of readmission trends enables the identification and proactive management of patients at higher risk for readmission. Source of Funding: UMKC Sarah Morrison Student Research Award © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e564-e565 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shiva Balasubramanian More articles by this author Xi Wang More articles by this author An-Lin Cheng More articles by this author Jignesh H. Shah More articles by this author William P. Parker More articles by this author Expand All Advertisement Loading ...