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Related Experiment Videos

Characterising 'bounce-back' readmissions after radical cystectomy.

Peter S Kirk1, Ted A Skolarus1,2, Bruce L Jacobs3

  • 1Dow Division of Health Services Research, Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA.

BJU International
|July 18, 2019
PubMed
Summary

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Early readmissions after radical cystectomy (RC) are common, with 5.6% occurring within 3 days. Predictors for these "bounce-back" readmissions remain unclear, necessitating further investigation into actionable clinical factors.

Area of Science:

  • Urology
  • Surgical Outcomes
  • Health Services Research

Background:

  • Radical cystectomy (RC) is a major surgery with significant readmission rates.
  • Early 'bounce-back' readmissions within 3 days of discharge are particularly concerning.
  • Identifying predictors for these early readmissions is crucial for improving patient care and reducing healthcare costs.

Purpose of the Study:

  • To examine predictors of early readmissions within 3 days (bounce-back) after radical cystectomy (RC).
  • To assess the utility of common readmission risk stratification algorithms, such as the abbreviated LACE score.

Main Methods:

  • Utilized the Healthcare Cost and Utilization Project's State Inpatient Databases.
  • Analyzed data from 1867 patients undergoing RC in 2009-2010.
Keywords:
#BladderCancer#blcsmCystectomyhospital readmissionspostoperative complications

Related Experiment Videos

  • Employed logistic regression models to compare 'bounce-back' readmissions with later readmissions (8-30 days).

    • Main Results:

    • The 30-day and bounce-back readmission rates were 28.4% and 5.6%, respectively.
    • No patient or index hospitalization characteristics were significantly associated with bounce-back readmissions in adjusted analyses.
    • Bounce-back patients had higher rates of gastrointestinal and wound diagnoses, and longer lengths of stay.

    Conclusions:

    • One in five readmissions after RC occurs within 3 days, likely due to factors present at discharge.
    • Sociodemographic, clinical factors, and traditional risk tools did not predict bounce-back readmissions.
    • Effective strategies to reduce bounce-back readmissions require identification of actionable clinical factors prior to discharge.