PD64-05 CLINICAL OUTCOMES FOR SAME-DAY VERSUS STANDARD-LENGTH DISCHARGE FOR MINIMALLY INVASIVE PARTIAL AND RADICAL NEPHRECTOMY USING A NATIONAL COHORT

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy VI (PD64)1 Sep 2021PD64-05 CLINICAL OUTCOMES FOR SAME-DAY VERSUS STANDARD-LENGTH DISCHARGE FOR MINIMALLY INVASIVE PARTIAL AND RADICAL NEPHRECTOMY USING A NATIONAL COHORT Evan Garden, Krishna Ravivarapu, Olamide Omidele, Nir Tomer, Osama Al-Alao, and Michael Palese Evan GardenEvan Garden More articles by this author , Krishna RavivarapuKrishna Ravivarapu More articles by this author , Olamide OmideleOlamide Omidele More articles by this author , Nir TomerNir Tomer More articles by this author , Osama Al-AlaoOsama Al-Alao More articles by this author , and Michael PaleseMichael Palese More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002108.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Minimally-invasive (MIS) partial (RN) and radical nephrectomy (PN) have resulted in shorter length of stay (LOS) for patients. Recent reports have described the safety of ambulatory MIS PN and RN with same-day discharge (SDD), but studies of this approach on a broader scale have not yet been conducted. Using a national cohort, we compared 30-day outcomes of SDD (LOS=0) versus standard-length discharge (SLD, LOS=1-3). METHODS: All patients who underwent MIS PN (CPT 50543) and RN (CPT 50545) in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database from 2012-2019 were reviewed. To mitigate selection bias, several exclusion criteria were used to refine the cohort to include patients reasonably eligible for SDD (Figure 1). Baseline characteristics, perioperative data, and postoperative outcomes were compared between SDD and SLD. Multivariable logistic regression was used to assess for predictors of 30-day Clavien-Dindo (CD) complications, reoperation, and readmission. RESULTS: 28,140 patients were studied (SDD n=237 [0.8%], SLD n=27,903 [99.2%]). SLD patients were more commonly white and overweight with ASA score = 3. There were no differences in 30-day complications or readmissions between SDD (CD I/II: 4.22%, CD III: 0%, CD IV: 1.27%, Readmission: 4.64%) and SLD (CD I/II: 4.11%, CD III: 0.95%, CD IV: 0.79%, Readmission: 3.90%) (all p>0.05) (Table 1). Controlling for demographic and clinical variables, SDD did not confer greater risk of 30-day complications or readmissions (CD I/II: OR 1.08, 95% CI 0.57-2.048, p=0.813; CD IV: OR 1.699, 95% CI: 0.537-5.375, p=0.367; Readmission: OR 1.254, 95% CI: 0.681-2.31, p=0.467). CONCLUSIONS: Same day discharge after minimally invasive partial and radical nephrectomy did not confer increased risk of postoperative complications, reoperation, or readmission. Further research should address study limitations like small sample size and lack of oncological data to explore optimal patient selection. Source of Funding: N/A © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1145-e1145 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Evan Garden More articles by this author Krishna Ravivarapu More articles by this author Olamide Omidele More articles by this author Nir Tomer More articles by this author Osama Al-Alao More articles by this author Michael Palese More articles by this author Expand All Advertisement Loading ...