MP96-17 LOWER SERUM ALBUMIN LEVELS ARE ASSOCIATED WITH LONGER LENGTHS OF STAY (LOS) FOLLOWING CYSTECTOMY: THE NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality Improvement & Patient Safety III1 Apr 2017MP96-17 LOWER SERUM ALBUMIN LEVELS ARE ASSOCIATED WITH LONGER LENGTHS OF STAY (LOS) FOLLOWING CYSTECTOMY: THE NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM Rohan Bhalla, Li Wang, Sam Chang, and Mark Tyson Rohan BhallaRohan Bhalla More articles by this author , Li WangLi Wang More articles by this author , Sam ChangSam Chang More articles by this author , and Mark TysonMark Tyson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.3040AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Serum albumin levels have been reported to be a valid measure of nutritional status for epidemiologic studies. However, contemporary population-based epidemiologic data evaluating the effect of preoperative albumin levels on LOS after cystectomy and urinary diversion is limited. In this study, we measure the relationship between preoperative serum albumin level and hospital LOS and hypothesized that decreasing preoperative albumin levels would be associated with increasing LOS. Such an association would strengthen the importance of preoperative nutritional optimization prior to cystectomy. METHODS Data was acquired from the 2014-2015 National Surgical Quality Improvement Program database. We identified 2,469 adult patients who underwent a cystectomy between January 1st 2014 and December 31st 2015. The primary outcome was hospital LOS and the primary exposure was preoperative albumin. We fit proportional odds logistic model with patient-level variables that were either known to be associated with increased LOS or that we had hypothesized would be prior to model fitting. We allowed all continuous variables to have a nonlinear relationship with the primary outcome using restricted cubic spline with 5 knots. RESULTS Multivariable proportional odds logistic regression determined that preoperative serum albumin was independently associated with LOS (OR: 0.81; 95% CI: 0.64-1.02; p<0.001). Figure 1 demonstrates that LOS increases significantly for patients with a serum albumin level of less than 4 g/dl. Other significant predictors include older age (OR 1.56; 95% CI 1.21-2.01; p<0.001), elevated BMI (OR 1.48; 95% CI 1.17-1.86; p<0.001), and non-Caucasian patients (OR 1.7; 95% CI 1.34-2.18; p<0.001). CONCLUSIONS This study provides evidence that lower preoperative serum albumin levels are associated with increasing LOS. Efforts to optimize a patient's nutritional status prior to cystectomy undoubtedly have many benefits, including a shorter LOS. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1301 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Rohan Bhalla More articles by this author Li Wang More articles by this author Sam Chang More articles by this author Mark Tyson More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...