Hospitalization before surgery and subsequent risk of infective complications after radical cystectomy: A population-based analysis
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Hospitalization before surgery and subsequent risk of infective complications after radical cystectomy: A population-based analysis. / Zaffuto, Emanuele; Pompe, Raisa; Bondarenko, Helen Davis; Moschini, Marco; Dell'Oglio, Paolo; Gandaglia, Giorgio; Fossati, Nicola; Shariat, Shahrokh F; Montorsi, Francesco; Briganti, Alberto; Karakiewicz, Pierre I.
In: UROL ONCOL-SEMIN ORI, Vol. 35, No. 11, 11.2017, p. 659.e7-659.e12.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Hospitalization before surgery and subsequent risk of infective complications after radical cystectomy: A population-based analysis
AU - Zaffuto, Emanuele
AU - Pompe, Raisa
AU - Bondarenko, Helen Davis
AU - Moschini, Marco
AU - Dell'Oglio, Paolo
AU - Gandaglia, Giorgio
AU - Fossati, Nicola
AU - Shariat, Shahrokh F
AU - Montorsi, Francesco
AU - Briganti, Alberto
AU - Karakiewicz, Pierre I
N1 - Copyright © 2017 Elsevier Inc. All rights reserved.
PY - 2017/11
Y1 - 2017/11
N2 - INTRODUCTION: The length of stay prior to surgery increases the risk of postoperative infections (PIs) in several surgical settings, such as cardiac, orthopedic, and general surgery. However, data for urological oncology procedures are limited. We examined PI rates after radical cystectomy (RC) according to the length of stay prior to RC (LOSPRC).MATERIALS AND METHODS: A total of 24,242 patients with bladder cancer treated with RC between 1998 and 2013 were abstracted from the National Inpatients Sample database. We evaluated changes over time in LOSPRC (0 vs. 1 vs. 2 days or more) and tested its effect on PI rates. Multivariable logistic regression analyses were adjusted for the year of surgery, sex, age, ethnicity, comorbidities, hospital location, teaching status, hospital surgical volume, and number of hospital beds.RESULTS: Overall, 19,401 (80.0%), 3,990 (16.5%), and 851 (3.5%) individuals with LOSPRC of 0, 1. and 2 or more were identified. The proportion of LOSPRC 0 patients increased from 61.4% in 1998 to 91.0% in 2013 (P<0.001), whereas the opposite trend was observed for LOSPRC 1 and 2 or more. In multivariable logistic regression analyses predicting PIs, LOSPRC of 1 (odds ratio: 1.38; 95% CI: 1.25-1.53; P<0.001) and LOSPRC of 2 or more (odds ratio: 2.15; 95% CI: 1.81-2.55; P<0.001) achieved independent predictor status.CONCLUSIONS: A delay in surgery as short as 1 day significantly increases the risk of PIs after RC. In consequence, same day of admission surgery policies should be further promoted to reduce the risk of PIs.
AB - INTRODUCTION: The length of stay prior to surgery increases the risk of postoperative infections (PIs) in several surgical settings, such as cardiac, orthopedic, and general surgery. However, data for urological oncology procedures are limited. We examined PI rates after radical cystectomy (RC) according to the length of stay prior to RC (LOSPRC).MATERIALS AND METHODS: A total of 24,242 patients with bladder cancer treated with RC between 1998 and 2013 were abstracted from the National Inpatients Sample database. We evaluated changes over time in LOSPRC (0 vs. 1 vs. 2 days or more) and tested its effect on PI rates. Multivariable logistic regression analyses were adjusted for the year of surgery, sex, age, ethnicity, comorbidities, hospital location, teaching status, hospital surgical volume, and number of hospital beds.RESULTS: Overall, 19,401 (80.0%), 3,990 (16.5%), and 851 (3.5%) individuals with LOSPRC of 0, 1. and 2 or more were identified. The proportion of LOSPRC 0 patients increased from 61.4% in 1998 to 91.0% in 2013 (P<0.001), whereas the opposite trend was observed for LOSPRC 1 and 2 or more. In multivariable logistic regression analyses predicting PIs, LOSPRC of 1 (odds ratio: 1.38; 95% CI: 1.25-1.53; P<0.001) and LOSPRC of 2 or more (odds ratio: 2.15; 95% CI: 1.81-2.55; P<0.001) achieved independent predictor status.CONCLUSIONS: A delay in surgery as short as 1 day significantly increases the risk of PIs after RC. In consequence, same day of admission surgery policies should be further promoted to reduce the risk of PIs.
KW - Journal Article
U2 - 10.1016/j.urolonc.2017.07.004
DO - 10.1016/j.urolonc.2017.07.004
M3 - SCORING: Journal article
C2 - 28755960
VL - 35
SP - 659.e7-659.e12
JO - UROL ONCOL-SEMIN ORI
JF - UROL ONCOL-SEMIN ORI
SN - 1078-1439
IS - 11
ER -