Readmission after major surgery is a common but understudied event. In this context, the attention on readmission after discharge is growing, as this parameter has recently been scrutinized as a driver of health care expenditure. We analyzed the incidence of 30-day readmission after robot-assisted radical prostatectomy. Patients in intermediate- to high-risk D'Amico groups and patients who incurred postoperative complications are at a higher risk of readmission. Objective To evaluate the incidence and predictors of 30-day readmission in prostate cancer (PCa) patients treated with robot-assisted radical prostatectomy (RARP). Patients and Methods Overall, 1402 consecutive PCa patients treated with RARP at a single center between 2006 and 2013 were identified. Uni- and multivariate logistic regression analyses assessed predictors of 30-day readmission after surgery. Results Overall, 38 patients (2.7%) experienced hospital readmission within 30 days after discharge. The most common causes of rehospitalization were fever in 12 patients (31.6%), lymphoceles in 11 (28.9%), and urine leak in 6 (15.8%). By multivariable analyses, D'Amico risk group and occurrence of postoperative complications (odds ratio [OR], 2.89) represented independent predictors of 30-day readmission (all P ≤ .02). When analyzing the type of complication associated with the risk of readmission, fever (OR, 6.19; P = .01), urine leak (OR, 10.83; P < .01) and cardiocirculatory complications (OR, 18.57; P < .001) were significantly associated with 30-day readmission. Conclusion Patients undergoing RARP have a relatively low risk of 30-day readmission (2.7%). The occurrence of an early postoperative complication and a higher D'Amico risk group were independent predictors of 30-day readmission. In addition, fever, urine leak, and cardiocirculatory complications are significantly associated with a higher risk of readmission.

Incidence and Predictors of 30-Day Readmission After Robot-Assisted Radical Prostatectomy / M. Moschini, G. Gandaglia, N. Fossati, P. Dell'Oglio, V. Cucchiara, S. Luzzago, E. Zaffuto, N. Suardi, R. Damiano, S.F. Shariat, F. Montorsi, A. Briganti. - In: CLINICAL GENITOURINARY CANCER. - ISSN 1558-7673. - 15:1(2017), pp. 67-71. [10.1016/j.clgc.2016.06.002]

Incidence and Predictors of 30-Day Readmission After Robot-Assisted Radical Prostatectomy

S. Luzzago;N. Suardi;F. Montorsi;
2017

Abstract

Readmission after major surgery is a common but understudied event. In this context, the attention on readmission after discharge is growing, as this parameter has recently been scrutinized as a driver of health care expenditure. We analyzed the incidence of 30-day readmission after robot-assisted radical prostatectomy. Patients in intermediate- to high-risk D'Amico groups and patients who incurred postoperative complications are at a higher risk of readmission. Objective To evaluate the incidence and predictors of 30-day readmission in prostate cancer (PCa) patients treated with robot-assisted radical prostatectomy (RARP). Patients and Methods Overall, 1402 consecutive PCa patients treated with RARP at a single center between 2006 and 2013 were identified. Uni- and multivariate logistic regression analyses assessed predictors of 30-day readmission after surgery. Results Overall, 38 patients (2.7%) experienced hospital readmission within 30 days after discharge. The most common causes of rehospitalization were fever in 12 patients (31.6%), lymphoceles in 11 (28.9%), and urine leak in 6 (15.8%). By multivariable analyses, D'Amico risk group and occurrence of postoperative complications (odds ratio [OR], 2.89) represented independent predictors of 30-day readmission (all P ≤ .02). When analyzing the type of complication associated with the risk of readmission, fever (OR, 6.19; P = .01), urine leak (OR, 10.83; P < .01) and cardiocirculatory complications (OR, 18.57; P < .001) were significantly associated with 30-day readmission. Conclusion Patients undergoing RARP have a relatively low risk of 30-day readmission (2.7%). The occurrence of an early postoperative complication and a higher D'Amico risk group were independent predictors of 30-day readmission. In addition, fever, urine leak, and cardiocirculatory complications are significantly associated with a higher risk of readmission.
Clavien-Dindo; Complications; Prostate cancer; Radical prostatectomy; RARP
Settore MED/24 - Urologia
2017
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/881589
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