MP81-19 PREDICTORS OF READMISSION FOLLOWING OPEN AND MINIMALLY INVASIVE SACRAL COLPOPEXY USING THE NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM (NSQIP) DATABASE

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Female Urology1 Apr 2015MP81-19 PREDICTORS OF READMISSION FOLLOWING OPEN AND MINIMALLY INVASIVE SACRAL COLPOPEXY USING THE NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM (NSQIP) DATABASE Ahmed Sarhan, Ahmad Shabsigh, and Ketul Shah Ahmed SarhanAhmed Sarhan More articles by this author , Ahmad ShabsighAhmad Shabsigh More articles by this author , and Ketul ShahKetul Shah More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2897AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Post-operative readmissions have a significant impact on the health care cost. They reflect the quality of care and the complexity of our patients. Our objective is to define the rates and the predictors of unplanned readmissions following open (OSC) and minimally invasive sacral colpopexy (MISC). METHODS We performed a retrospective review of prospectively collected database (NSQIP) of all patients who underwent open and minimally invasive sacral colpopexy between 2005 and 2012. Patient's demographics, unplanned readmission rate and its causes were reported. Multivariate analysis was performed to characterize predictors of readmission. RESULTS Between 2005 and 2012, a total of 1520 cases were identified. Data regarding readmission rates and possible causes of readmission was available for 2011 and 2012 dataset. Between 2011 and 2012, 1049 underwent sacral colpopexy. 386 patients (36.8%) underwent open sacral colpopexy (OSC) while 663 patients (63.2%) were managed through minimally invasive sacral colpopexy (MISC). Unplanned readmission and reoperation rates were comparable between the two groups (2.3% vs. 3.3%, P= 0.24 and 1.6% vs. 1.8%, P= 0.49 respectively). For both groups, postoperative ileus was the most common causes of readmission but it was significantly higher in OSC group accounting for 44.4% of total readmissions in OSC and 9.1% for MISC group (P= 0.043), other common causes for readmission in OSC group were surgical site infection (11.1 %) and pulmonary embolism (11.1 %). For MISC, other common causes of readmission were postoperative fever (9 %) and unspecified abdominal pain (4.5%). %). Logistic regression analysis was performed to define the predictors of readmission. For OSC, preoperative blood urea nitrogen (BUN) was the only significant predictor for OSC (OR 1.4, 95% CI 1.05-1.87, P= 0.02) while for MISC preoperative serum albumin was the only significant predictor (OR 0.17, 95% CI 0.04-0.67, P= 0.012) and hypertension was near significant predictor (OR 4.5, 95% CI 0.86-23.87, P=0.75). CONCLUSIONS Both OSC and MISC have comparable readmission and reoperation rates. Predictors of readmission vary between different treatment options and selection of approach should be based on general condition as well as local factors. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1036 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ahmed Sarhan More articles by this author Ahmad Shabsigh More articles by this author Ketul Shah More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...