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J Urol. 2014 Jul;192(1):112-9. doi: 10.1016/j.juro.2014.01.109. Epub 2014 Feb 4.

Rehospitalization after radical prostatectomy in a nationwide, population based study.

Author information

1
Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden. Electronic address: jon.fridriksson@urologi.umu.se.
2
Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Göteborg, Göteborg, Sweden.
3
Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
4
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Regional Cancer Centre, Uppsala University Hospital, Uppsala, Sweden.
5
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
6
Section of Urology, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
7
Department of Urology, Sahlgrenska University Hospital, Göteborg, Sweden.
8
Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden.

Abstract

PURPOSE:

We investigated hospital readmission frequency during the 90 days after radical prostatectomy and assessed the readmission risk associated with potentially related variables.

MATERIALS AND METHODS:

Using the population based, nationwide PCBaSe (Prostate Cancer data Base Sweden) we identified men diagnosed with incident prostate cancer between 2000 and 2011 who underwent radical prostatectomy as primary treatment. We used logistic regression analysis to examine the association of the risk of 90-day postoperative readmission with surgical method, calendar period, tumor risk category, hospital case load and patient characteristics.

RESULTS:

During 90 postoperative days 2,317 of the 24,122 men (10%) identified were nonelectively readmitted, specifically 10% after retropubic, 9% after robot-assisted and 11% after laparoscopic radical prostatectomy. The range in readmission frequency among hospitals was 0% to 35%. Higher readmission risk was associated with the early calendar period (2009 to 2011 vs 2000 to 2002 OR 0.71, 95% CI 0.61-0.83), greater age (70 or greater vs less than 60 years OR 1.17, 95% CI 1.00-1.36), higher risk category (high vs low OR 1.78, 95% CI 1.57-2.03), high comorbidity (Charlson comorbidity index 3 or greater vs 0 OR 1.77, 95% CI 1.29-2.44) and low hospital surgical volume (150 or greater vs fewer than 30 radical prostatectomies per year OR 0.70, 95% CI 0.60-0.81).

CONCLUSIONS:

Readmission rates after different radical prostatectomy methods were similar, ranging from 9% to 11%, with wide variation among hospitals. Readmission rates can be used as an indicator of perioperative care quality but potential confounders must be adjusted to avoid bias.

KEYWORDS:

patient readmission; perioperative care; prostate; prostatectomy; prostatic neoplasms

PMID:
24508613
DOI:
10.1016/j.juro.2014.01.109
[Indexed for MEDLINE]

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