Causes of hospital readmissions after urologic cancer surgery
Standard
Causes of hospital readmissions after urologic cancer surgery. / Schmid, Marianne; Chiang, H Abraham; Sood, Akshay; Campbell, Logan; Chun, Felix K-H; Dalela, Deepansh; Okwara, James; Sammon, Jesse D; Kibel, Adam S; Menon, Mani; Fisch, Margit; Trinh, Quoc-Dien.
in: UROL ONCOL-SEMIN ORI, Jahrgang 34, Nr. 5, 05.2016, S. 236.e1-11.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Causes of hospital readmissions after urologic cancer surgery
AU - Schmid, Marianne
AU - Chiang, H Abraham
AU - Sood, Akshay
AU - Campbell, Logan
AU - Chun, Felix K-H
AU - Dalela, Deepansh
AU - Okwara, James
AU - Sammon, Jesse D
AU - Kibel, Adam S
AU - Menon, Mani
AU - Fisch, Margit
AU - Trinh, Quoc-Dien
N1 - Copyright © 2016 Elsevier Inc. All rights reserved.
PY - 2016/5
Y1 - 2016/5
N2 - OBJECTIVES: The Hospital Readmissions Reduction Program mandates reimbursement reductions to hospitals with higher than expected rates of readmissions. We examine causes and predictors of readmissions following major procedures in urologic oncology.MATERIALS AND METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program database, patients undergoing radical prostatectomy (RP), radical (RN) or partial nephrectomy (PN), and radical cystectomy (RC) during the year 2012 were abstracted. Rates of unplanned readmission within 30 days after surgery, as well as causes of readmission, were identified. Multivariable logistic regression models were fitted to examine the association between patient perioperative factors and odds of readmission.RESULTS: Overall, we observed a 5.5% unplanned 30-day readmission rate. Readmission rates for patients treated with RP, RN, PN, and RC were 4.1%, 5.2%, 4.5%, and 15.9%, respectively. For each procedure, approximately two-third of readmissions occurred within the first 10 days following hospital discharge. Commonest causes of readmission after RP included thromboembolic (13.6%), wound (12.2%), renal/genitourinary (12.2%), and gastrointestinal (11.8%); after RN, wound (12.9%) and gastrointestinal (12.9%); after PN, renal/genitourinary (19.6%), cardiovascular (9.8%), and bleeding/hematoma (9.8%); and after RC, renal/genitourinary (15.5%), wound (14.8%), and sepsis/infection (14.1%). RC was significantly associated with readmission. Patients undergoing open RP or PN were more likely to be readmitted relative to their minimally invasive counterparts (odds ratio = 1.53, 95% CI: 1.12-2.08, P = 0.007 and odds ratio = 2.51, 95% CI: 1.38-4.55, P = 0.003, respectively).CONCLUSIONS: Readmissions are relatively common following major urologic oncology procedures. Compared with RP, RN, or PN, RC patients experience the highest burden of readmission. Venous thromboembolism is a common modifiable cause of readmission following urologic cancer surgery. Minimally invasive approach is associated with decreased odds of readmission following RP and PN.
AB - OBJECTIVES: The Hospital Readmissions Reduction Program mandates reimbursement reductions to hospitals with higher than expected rates of readmissions. We examine causes and predictors of readmissions following major procedures in urologic oncology.MATERIALS AND METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program database, patients undergoing radical prostatectomy (RP), radical (RN) or partial nephrectomy (PN), and radical cystectomy (RC) during the year 2012 were abstracted. Rates of unplanned readmission within 30 days after surgery, as well as causes of readmission, were identified. Multivariable logistic regression models were fitted to examine the association between patient perioperative factors and odds of readmission.RESULTS: Overall, we observed a 5.5% unplanned 30-day readmission rate. Readmission rates for patients treated with RP, RN, PN, and RC were 4.1%, 5.2%, 4.5%, and 15.9%, respectively. For each procedure, approximately two-third of readmissions occurred within the first 10 days following hospital discharge. Commonest causes of readmission after RP included thromboembolic (13.6%), wound (12.2%), renal/genitourinary (12.2%), and gastrointestinal (11.8%); after RN, wound (12.9%) and gastrointestinal (12.9%); after PN, renal/genitourinary (19.6%), cardiovascular (9.8%), and bleeding/hematoma (9.8%); and after RC, renal/genitourinary (15.5%), wound (14.8%), and sepsis/infection (14.1%). RC was significantly associated with readmission. Patients undergoing open RP or PN were more likely to be readmitted relative to their minimally invasive counterparts (odds ratio = 1.53, 95% CI: 1.12-2.08, P = 0.007 and odds ratio = 2.51, 95% CI: 1.38-4.55, P = 0.003, respectively).CONCLUSIONS: Readmissions are relatively common following major urologic oncology procedures. Compared with RP, RN, or PN, RC patients experience the highest burden of readmission. Venous thromboembolism is a common modifiable cause of readmission following urologic cancer surgery. Minimally invasive approach is associated with decreased odds of readmission following RP and PN.
KW - Aged
KW - Cystectomy
KW - Female
KW - Humans
KW - Logistic Models
KW - Male
KW - Middle Aged
KW - Minimally Invasive Surgical Procedures
KW - Multivariate Analysis
KW - Nephrectomy
KW - Patient Readmission
KW - Postoperative Complications
KW - Prostatectomy
KW - Urologic Neoplasms
KW - Venous Thromboembolism
KW - Journal Article
U2 - 10.1016/j.urolonc.2015.11.019
DO - 10.1016/j.urolonc.2015.11.019
M3 - SCORING: Journal article
C2 - 26712365
VL - 34
SP - 236.e1-11
JO - UROL ONCOL-SEMIN ORI
JF - UROL ONCOL-SEMIN ORI
SN - 1078-1439
IS - 5
ER -
