Impact of Patient, Surgical, and Perioperative Factors on Discharge Disposition after Radical Cystectomy

Radical cystectomy (RC) is a complex procedure associated with lengthy hospital stays and high complication and readmission rates. We evaluated the impact of patient, surgical, and perioperative factors on discharge disposition following RC at a tertiary referral center. From 2012 to 2019, all bladd...

Full description

Saved in:
Bibliographic Details
Published in:Cancers 2022-10, Vol.14 (21), p.5288
Main Authors: Cacciamani, Giovanni E, Lee, Ryan S, Sanford, Daniel I, Yip, Wesley, Cai, Jie, Miranda, Gus, Daneshmand, Siamak, Aron, Monish, Djaladat, Hooman, Gill, Inderbir S, Desai, Mihir
Format: Article
Language:English
Subjects:
Age
Bladder cancer
Body mass index
Cancer therapies
Care and treatment
Chemotherapy
Complications
Cystectomy
Health care policy
Hospitals
Length of stay
Medical prognosis
Medicare
Methods
Mortality
Multivariate analysis
Nursing
Patient outcomes
Patients
Postoperative
Recovery (Medical)
Rehabilitation
Surgeons
Surgery
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Radical cystectomy (RC) is a complex procedure associated with lengthy hospital stays and high complication and readmission rates. We evaluated the impact of patient, surgical, and perioperative factors on discharge disposition following RC at a tertiary referral center. From 2012 to 2019, all bladder cancer patients undergoing RC at our institution were identified (n = 1153). Patients were classified based on discharge disposition: to home or to continued facility-based rehabilitation centers (CFRs, n = 180 (15.61%) patients). On multivariate analysis of patient factors only, age [Risk Ratio (RR): 1.07, p < 0.001)], single marital status (RR: 1.09, p < 0.001), and living alone prior to surgery (RR: 2.55, p = 0.004) were significant predictors of discharge to CFRs. Multivariate analysis of patient, surgical, and perioperative factors indicated age (RR: 1.09, p < 0.001), single marital status (RR: 3.9, p < 0.001), living alone prior to surgery (RR: 2.42, p = 0.01), and major post-operative (Clavien > 3) complications (RR: 3.44, p < 0.001) were significant independent predictors of discharge to CFRs. Of note, ERAS did not significantly impact discharge disposition. Specific patient and perioperative factors significantly impact discharge disposition. Patients who are older, living alone prior to surgery, and/or have a major post-operative complication are more likely to be discharged to CFRs after RC.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers14215288