MP96-05 PRE-DISCHARGE PREDICTORS OF READMISSIONS AND POST-DISCHARGE COMPLICATIONS IN ROBOT-ASSISTED RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality Improvement & Patient Safety III1 Apr 2017MP96-05 PRE-DISCHARGE PREDICTORS OF READMISSIONS AND POST-DISCHARGE COMPLICATIONS IN ROBOT-ASSISTED RADICAL PROSTATECTOMY Leilei Xia, Benjamin Taylor, Jeremy Bonzo, Jose Pulido, and Thomas Guzzo Leilei XiaLeilei Xia More articles by this author , Benjamin TaylorBenjamin Taylor More articles by this author , Jeremy BonzoJeremy Bonzo More articles by this author , Jose PulidoJose Pulido More articles by this author , and Thomas GuzzoThomas Guzzo More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.3028AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Robot-assisted radical prostatectomy (RARP) has become the main surgical treatment for localized prostate cancer in the United States. Little is reported about the association between pre-discharge complications and post-discharge outcomes following RARP. The objective of this study was to explore the pre-discharge predictors of readmissions and post-discharge complications in RARP. METHODS The National Surgery Quality Improvement Program (NSQIP) database was used to identify prostate cancer patients who underwent elective RARP from 2012 to 2014. Additional exclusion criteria were utilized to control heterogeneity. Multivariable logistic regression was performed to assess potential pre-discharge predictors of readmissions and post-discharge complications within 30 days of RARP. RESULTS A total of 9,975 patients were included. The readmission rate in the cohort was 3.3% (n = 332), and 4.4% (n = 441) had at least 1 complication. Figure 1 shows the causes of readmissions and distributions of 30-days complications. Multivariable logistic regression showed that increased operative time (OT) (OR = 1.002, 95%CI = 1.001-1.003, P = 0.007), increased length of stay (LOS) (OR = 1.35, 95%CI = 1.23-1.48, P < 0.001), and a pre-discharge complication (OR = 2.24, 95%CI = 1.33-3.76, P = 0.002) were associated with readmission. Increased OT (OR = 1.002, 95%CI = 1.001-1.004, P = 0.003) and increased LOS (OR = 1.16, 95%CI = 1.02-1.30, P = 0.019) were associated with post-discharge complications. Logistic regression in patients without pre-discharge complications (n = 9,804) confirmed that increased OT (OR = 1.002, 95%CI = 1.000-1.003, P = 0.014) and increased LOS (OR = 1.34, 95%CI = 1.20-1.48, P < 0.001) were associated with readmissions. The results also confirmed that increased OT (OR = 1.002, 95%CI = 1.001-1.004, P = 0.003) and increased LOS (OR = 1.18, 95%CI = 1.04-1.34, P = 0.010) were associated with post-discharge complications. CONCLUSIONS Pre-discharge complications, OT, and LOS, appear to be associated with post-discharge morbidity outcomes in RARP. Identifying modifiable risk factors for complications and readmissions as well as developing post-operative surgical pathways is a high priority in delivering quality care. Further prospective studies are needed to validate our findings. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1295-e1296 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Leilei Xia More articles by this author Benjamin Taylor More articles by this author Jeremy Bonzo More articles by this author Jose Pulido More articles by this author Thomas Guzzo More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...