Readmission after robot-assisted radical cystectomy

Outcomes and predictors at 90-day follow-up

Ali Al-Daghmin, Ahmed Aboumohamed, Rakeeba Din, Aabroo Khan, Syed Johar Raza, Jenna Sztorc, Diana Mehedint, Mohammad Sharif, Yi Shi, Gregory Wilding, Khurshid A. Guru

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Objective To characterize the outcomes and predictors of readmission after robot-assisted radical cystectomy (RARC) during early (30-day) and late (31-90-day) postoperative periods. Methods We retrospectively evaluated our prospectively maintained RARC quality assurance database of 272 consecutive patients operated between 2005 and 2012. We evaluated the relationship of readmission with perioperative outcomes and examined possible predictors during the postoperative period. Results Overall 30- and 90-day mortality was 0.7% and 4.8%, respectively, with 25.5% patients readmitted within 90 days after RARC (61% of them were readmitted within 30 days and 39% were readmitted between 31-90 days postoperatively). Infection-related problems were the most common cause of readmission during early and late periods. Overall operative time and obesity were significantly associated with readmission (P =.034 and.033, respectively). Body mass index and female gender were independent predictors of 90-day readmission (P =.004 and.014, respectively). Having any type of complication correlated with 90-day readmission (P =.0045); meanwhile, when complications were graded on the basis of Clavien grading system, only grade 1-2 complications statistically correlated with readmission (P =.046). Four patients needed reoperation (2 patients in early "for appendicitis and adhesive small bowel obstruction" and 2 in late "for ureteroenteric stricture" readmission); meanwhile, 6 patients needed percutaneous procedures (4 patients in early "1 for anastomotic leak and 3 for pelvic collections" and 2 "for pelvic collections and ureterocutaneous fistula" in late readmission). Conclusion The rate of readmission within 90 days after RARC is significant. Female gender and body mass index are independent predictors of readmission. Outcomes at 90 days provide more thorough results, essential to proper patient counseling.

Original languageEnglish (US)
Pages (from-to)350-356
Number of pages7
JournalUrology
Volume83
Issue number2
DOIs
StatePublished - Feb 1 2014
Externally publishedYes

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Cystectomy
Postoperative Period
Body Mass Index
Anastomotic Leak
Appendicitis
Operative Time
Reoperation
Adhesives
Fistula
Counseling
Pathologic Constriction
Obesity
Databases
Mortality
Infection

ASJC Scopus subject areas

  • Urology

Cite this

Readmission after robot-assisted radical cystectomy : Outcomes and predictors at 90-day follow-up. / Al-Daghmin, Ali; Aboumohamed, Ahmed; Din, Rakeeba; Khan, Aabroo; Raza, Syed Johar; Sztorc, Jenna; Mehedint, Diana; Sharif, Mohammad; Shi, Yi; Wilding, Gregory; Guru, Khurshid A.

In: Urology, Vol. 83, No. 2, 01.02.2014, p. 350-356.

Research output: Contribution to journalArticle

Al-Daghmin, A, Aboumohamed, A, Din, R, Khan, A, Raza, SJ, Sztorc, J, Mehedint, D, Sharif, M, Shi, Y, Wilding, G & Guru, KA 2014, 'Readmission after robot-assisted radical cystectomy: Outcomes and predictors at 90-day follow-up', Urology, vol. 83, no. 2, pp. 350-356. https://doi.org/10.1016/j.urology.2013.09.056
Al-Daghmin, Ali ; Aboumohamed, Ahmed ; Din, Rakeeba ; Khan, Aabroo ; Raza, Syed Johar ; Sztorc, Jenna ; Mehedint, Diana ; Sharif, Mohammad ; Shi, Yi ; Wilding, Gregory ; Guru, Khurshid A. / Readmission after robot-assisted radical cystectomy : Outcomes and predictors at 90-day follow-up. In: Urology. 2014 ; Vol. 83, No. 2. pp. 350-356.
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abstract = "Objective To characterize the outcomes and predictors of readmission after robot-assisted radical cystectomy (RARC) during early (30-day) and late (31-90-day) postoperative periods. Methods We retrospectively evaluated our prospectively maintained RARC quality assurance database of 272 consecutive patients operated between 2005 and 2012. We evaluated the relationship of readmission with perioperative outcomes and examined possible predictors during the postoperative period. Results Overall 30- and 90-day mortality was 0.7{\%} and 4.8{\%}, respectively, with 25.5{\%} patients readmitted within 90 days after RARC (61{\%} of them were readmitted within 30 days and 39{\%} were readmitted between 31-90 days postoperatively). Infection-related problems were the most common cause of readmission during early and late periods. Overall operative time and obesity were significantly associated with readmission (P =.034 and.033, respectively). Body mass index and female gender were independent predictors of 90-day readmission (P =.004 and.014, respectively). Having any type of complication correlated with 90-day readmission (P =.0045); meanwhile, when complications were graded on the basis of Clavien grading system, only grade 1-2 complications statistically correlated with readmission (P =.046). Four patients needed reoperation (2 patients in early {"}for appendicitis and adhesive small bowel obstruction{"} and 2 in late {"}for ureteroenteric stricture{"} readmission); meanwhile, 6 patients needed percutaneous procedures (4 patients in early {"}1 for anastomotic leak and 3 for pelvic collections{"} and 2 {"}for pelvic collections and ureterocutaneous fistula{"} in late readmission). Conclusion The rate of readmission within 90 days after RARC is significant. Female gender and body mass index are independent predictors of readmission. Outcomes at 90 days provide more thorough results, essential to proper patient counseling.",
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T1 - Readmission after robot-assisted radical cystectomy

T2 - Outcomes and predictors at 90-day follow-up

AU - Al-Daghmin, Ali

AU - Aboumohamed, Ahmed

AU - Din, Rakeeba

AU - Khan, Aabroo

AU - Raza, Syed Johar

AU - Sztorc, Jenna

AU - Mehedint, Diana

AU - Sharif, Mohammad

AU - Shi, Yi

AU - Wilding, Gregory

AU - Guru, Khurshid A.

PY - 2014/2/1

Y1 - 2014/2/1

N2 - Objective To characterize the outcomes and predictors of readmission after robot-assisted radical cystectomy (RARC) during early (30-day) and late (31-90-day) postoperative periods. Methods We retrospectively evaluated our prospectively maintained RARC quality assurance database of 272 consecutive patients operated between 2005 and 2012. We evaluated the relationship of readmission with perioperative outcomes and examined possible predictors during the postoperative period. Results Overall 30- and 90-day mortality was 0.7% and 4.8%, respectively, with 25.5% patients readmitted within 90 days after RARC (61% of them were readmitted within 30 days and 39% were readmitted between 31-90 days postoperatively). Infection-related problems were the most common cause of readmission during early and late periods. Overall operative time and obesity were significantly associated with readmission (P =.034 and.033, respectively). Body mass index and female gender were independent predictors of 90-day readmission (P =.004 and.014, respectively). Having any type of complication correlated with 90-day readmission (P =.0045); meanwhile, when complications were graded on the basis of Clavien grading system, only grade 1-2 complications statistically correlated with readmission (P =.046). Four patients needed reoperation (2 patients in early "for appendicitis and adhesive small bowel obstruction" and 2 in late "for ureteroenteric stricture" readmission); meanwhile, 6 patients needed percutaneous procedures (4 patients in early "1 for anastomotic leak and 3 for pelvic collections" and 2 "for pelvic collections and ureterocutaneous fistula" in late readmission). Conclusion The rate of readmission within 90 days after RARC is significant. Female gender and body mass index are independent predictors of readmission. Outcomes at 90 days provide more thorough results, essential to proper patient counseling.

AB - Objective To characterize the outcomes and predictors of readmission after robot-assisted radical cystectomy (RARC) during early (30-day) and late (31-90-day) postoperative periods. Methods We retrospectively evaluated our prospectively maintained RARC quality assurance database of 272 consecutive patients operated between 2005 and 2012. We evaluated the relationship of readmission with perioperative outcomes and examined possible predictors during the postoperative period. Results Overall 30- and 90-day mortality was 0.7% and 4.8%, respectively, with 25.5% patients readmitted within 90 days after RARC (61% of them were readmitted within 30 days and 39% were readmitted between 31-90 days postoperatively). Infection-related problems were the most common cause of readmission during early and late periods. Overall operative time and obesity were significantly associated with readmission (P =.034 and.033, respectively). Body mass index and female gender were independent predictors of 90-day readmission (P =.004 and.014, respectively). Having any type of complication correlated with 90-day readmission (P =.0045); meanwhile, when complications were graded on the basis of Clavien grading system, only grade 1-2 complications statistically correlated with readmission (P =.046). Four patients needed reoperation (2 patients in early "for appendicitis and adhesive small bowel obstruction" and 2 in late "for ureteroenteric stricture" readmission); meanwhile, 6 patients needed percutaneous procedures (4 patients in early "1 for anastomotic leak and 3 for pelvic collections" and 2 "for pelvic collections and ureterocutaneous fistula" in late readmission). Conclusion The rate of readmission within 90 days after RARC is significant. Female gender and body mass index are independent predictors of readmission. Outcomes at 90 days provide more thorough results, essential to proper patient counseling.

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