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01-05-2020 | Prostatectomy | Urologic Oncology

Prolonged Length of Stay After Robotic Prostatectomy: Causes and Risk Factors

Authors: Marshall C. Strother, MD, Katharine F. Michel, BA, Leilei Xia, MD, Kellie McWilliams, MS, Thomas J. Guzzo, MD, MPH, Daniel J. Lee, MD, MS, David I. Lee, MD, FACS

Published in: Annals of Surgical Oncology | Issue 5/2020

Abstract

Background

Robot-assisted radical prostatectomy (RARP) can generally be performed with 1–2 nights of postoperative monitoring before discharge from the hospital. Little is known about what causes individual patients to remain in hospital beyond the second postoperative day.

Methods

Data for RARPs performed between 2013 and 2015 were extracted from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. The fraction of cases with prolonged length of stay (PLOS) that can be reasonably attributed to complications was examined. Logistic regression was performed to identify risk factors for PLOS in the overall population and separately in the population of patients with PLOS without any perioperative complications.

Results

Of 11,440 patients, 10,342 (90.4%) were discharged on postoperative days 0–2; 80.6% (887/1101) of patients with PLOS did not experience any perioperative complications. The most common complication was bleeding requiring transfusion, but this was present in only 5.6% (62/1101) of patients with PLOS. Logistic regression identified predictors of PLOS as age, race, wound class, American Society of Anesthesiologists class, smoking, diabetes, dyspnea, dependent functional health status, congestive heart failure, operative time, and pelvic lymph node dissection. Results of this regression were insensitive to the exclusion of patients who experienced no perioperative complications.

Conclusions

This study utilizes logistic regression on NSQIP data to identify risk factors for PLOS after RARP and, in particular, to evaluate the role of postoperative complications in PLOS. The analysis shows that postoperative complications account for a small minority of cases of PLOS after RARP.

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Title: Prolonged Length of Stay After Robotic Prostatectomy: Causes and Risk Factors
Authors: Marshall C. Strother, MD
Katharine F. Michel, BA
Leilei Xia, MD
Kellie McWilliams, MS
Thomas J. Guzzo, MD, MPH
Daniel J. Lee, MD, MS
David I. Lee, MD, FACS
Publication date: 01-05-2020
Publisher: Springer International Publishing
Keywords: Prostatectomy
Prostatectomy
Published in: Annals of Surgical Oncology / Issue 5/2020
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-020-08266-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prolonged Length of Stay After Robotic Prostatectomy: Causes and Risk Factors

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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