Timing, Patterns and Predictors of 90-Day Readmission Rate after Robotic Radical Cystectomy
2020; Lippincott Williams & Wilkins; Volume: 205; Issue: 2 Linguagem: Inglês
10.1097/ju.0000000000001387
ISSN1527-3792
AutoresGiovanni Cacciamani, Luis G. Medina, Michael Lin‐Brande, Alessandro Tafuri, Ryan S. Lee, Saum Ghodoussipour, Akbar Ashrafi, Matthew Winter, Nariman Ahmadi, Nieroshan Rajarubendra, Gus Miranda, Andre De Castro Abreu, André Berger, Monish Aron, Inderbir S. Gill, Mihir Desai,
Tópico(s)Urological Disorders and Treatments
ResumoNo AccessJournal of UrologyAdult Urology1 Feb 2021Timing, Patterns and Predictors of 90-Day Readmission Rate after Robotic Radical Cystectomy Giovanni E. Cacciamani, Luis Medina, Michael Lin-Brande, Alessandro Tafuri, Ryan S. Lee, Saum Ghodoussipour, Akbar N. Ashrafi, Matthew Winter, Nariman Ahmadi, Nieroshan Rajarubendra, Gus Miranda, Andre De Castro Abreu, Andre Berger, Monish Aron, Inderbir S. Gill, and Mihir Desai Giovanni E. CacciamaniGiovanni E. Cacciamani USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California , Luis MedinaLuis Medina USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California , Michael Lin-BrandeMichael Lin-Brande USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California , Alessandro TafuriAlessandro Tafuri USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California , Ryan S. LeeRyan S. Lee USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California , Saum GhodoussipourSaum Ghodoussipour USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California , Akbar N. AshrafiAkbar N. Ashrafi USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California , Matthew WinterMatthew Winter USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California , Nariman AhmadiNariman Ahmadi USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California , Nieroshan RajarubendraNieroshan Rajarubendra USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California , Gus MirandaGus Miranda USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California , Andre De Castro AbreuAndre De Castro Abreu USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California , Andre BergerAndre Berger USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California , Monish AronMonish Aron USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California , Inderbir S. GillInderbir S. Gill USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California , and Mihir DesaiMihir Desai *Correspondence: Catherine & Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, 1441 Eastlake Avenue, Suite 7416, Los Angeles, California 90089-2211 USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California View All Author Informationhttps://doi.org/10.1097/JU.0000000000001387AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We examine the timing, patterns and predictors of 90-day readmission after robotic radical cystectomy. Materials and Methods: From September 2009 to March 2017, 271 consecutive patients undergoing robotic radical cystectomy with intent to cure bladder cancer (intracorporeal diversion 253, 93%) were identified from our prospectively collated institutional database. Readmission was defined as any subsequent inpatient admission or unplanned visit occurring within 90 days from discharge after the index hospitalization. Multiple readmissions were defined as 2 or more readmissions within a 90-day period. Logistic regression analysis was used to identify independent factors related to single and multiple 90-day readmissions. Results: A total of 78 (28.8%) patients were readmitted at least once within 90 days after discharge, of whom 20 (25.6%) reported multiple readmissions. The cumulative duration of readmission was 6.2 (6.17) days with 6 (7.6%) patients having less than 24 hours readmission. Metabolic, infectious, genitourinary and gastrointestinal complications were identified as the primary cause of readmission in 39.5%, 23.5%, 22.3% and 17%, respectively. Fifty percent of readmissions occurred in the first 2 weeks after hospital discharge. On multivariable logistic regression analysis in-hospital infections (OR 2.85, p=0.001) were independent predictors for overall readmission. Male gender (OR 3.5, p=0.02) and in-hospital infections (OR 4.35, p=0.002) were independent predictors for multiple readmissions. Conclusions: The 90-day readmission rate following robotic radical cystectomy is significant. In-hospital infections and male gender were independent factors for readmission. Most readmissions occurred in the first 2 weeks following discharge, with metabolic derangements and infections being the most common causes. References 1. : ICUD-EAU International Consultation on Bladder Cancer 2012: urinary diversion. Eur Urol 63: 67. 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Link, Google Scholar No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 205Issue 2February 2021Page: 491-499 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.Keywordspatient readmissionrobotics, cystectomyMetricsAuthor Information Giovanni E. Cacciamani USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California More articles by this author Luis Medina USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California More articles by this author Michael Lin-Brande USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California More articles by this author Alessandro Tafuri USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California More articles by this author Ryan S. Lee USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California More articles by this author Saum Ghodoussipour USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California More articles by this author Akbar N. Ashrafi USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California More articles by this author Matthew Winter USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California More articles by this author Nariman Ahmadi USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California More articles by this author Nieroshan Rajarubendra USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California More articles by this author Gus Miranda USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California More articles by this author Andre De Castro Abreu USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California More articles by this author Andre Berger USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California More articles by this author Monish Aron USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California More articles by this author Inderbir S. Gill USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California More articles by this author Mihir Desai USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California *Correspondence: Catherine & Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, 1441 Eastlake Avenue, Suite 7416, Los Angeles, California 90089-2211 More articles by this author Expand All No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Advertisement PDF DownloadLoading ...
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