MP75-06 POST-HOSPITAL SYNDROME IS A TRANSIENT PREDICTOR OF 30-DAY HOSPITAL READMISSION FOLLOWING TRANSVAGINAL MIDURETHRAL SLING PLACEMENT

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Incontinence: Therapy III1 Apr 2018MP75-06 POST-HOSPITAL SYNDROME IS A TRANSIENT PREDICTOR OF 30-DAY HOSPITAL READMISSION FOLLOWING TRANSVAGINAL MIDURETHRAL SLING PLACEMENT Marc Nelson, Spencer Hart, Eric Kirshenbaum, Yufan Chen, Michelle Van Kuiken, and Elizabeth Mueller Marc NelsonMarc Nelson More articles by this author , Spencer HartSpencer Hart More articles by this author , Eric KirshenbaumEric Kirshenbaum More articles by this author , Yufan ChenYufan Chen More articles by this author , Michelle Van KuikenMichelle Van Kuiken More articles by this author , and Elizabeth MuellerElizabeth Mueller More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2098AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES An acquired, transient period of health vulnerability known as post-hospital syndrome (PHS) has recently been described in surgical and non-surgical patient populations. Relative decline in nutrition, sleep, overall conditioning, and the immune system are postulated to account for PHS, which has been described as an independent risk factor for adverse outcomes. The aim of this study is to explore the effect of recent hospitalization on surgical outcomes following transvaginal midurethral sling (TMUS) placement in females for the treatment of stress incontinence. METHODS The Healthcare Cost and Utilization Project State Inpatient and Ambulatory Surgery Databases for California between 2007-2011 were linked and utilized. Patients were identified as having undergone outpatient transvaginal midurethral sling placement by CPT code for sling operation for stress incontinence (57288). The primary exposure was PHS, defined as any inpatient admission within 90 days prior to sling placement. Patients with inpatient hospitalizations within one year of sling procedure were categorized based on timing of prior admission (0-90, 91-180, 181-270, 271-360 days) and analyzed. The primary outcome was 30-day readmissions. A multivariable logistic regression model controlling for age, race, insurance status, and comorbidities was fit to assess independent predictors of readmission. RESULTS 39,908 female patients who underwent TMUS were identified. Overall 30-day readmission rate was 0.87%. Risk-adjusted 30-day hospital readmissions were significantly higher in patients with PHS (OR 4.15 (CI 2.86-6.02)). Furthermore, the risk of hospital readmission was time-dependent. See Figure 1. CONCLUSIONS Hospitalization within 90 days (PHS) of transvaginal mid-urethral sling placement is a risk-adjusted, independent predictor of 30-day hospital readmission following surgery. This increased vulnerability diminishes over time and returns to baseline at 180 days. Clinical and surgical outcomes may be improved with consideration of prior hospitalizations in determining the timing of transvaginal midurethral sling placement for stress urinary incontinence. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1010 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Marc Nelson More articles by this author Spencer Hart More articles by this author Eric Kirshenbaum More articles by this author Yufan Chen More articles by this author Michelle Van Kuiken More articles by this author Elizabeth Mueller More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...