Department of Urology, University of Arkansas for Medical Sciences, 4301 West Markham St., Little Rock, AR, USA.
Department of Urology, Ain Shams University, Cairo, Egypt.
Int Urol Nephrol. 2020 Jul;52(7):1279-1286. doi: 10.1007/s11255-020-02410-4. Epub 2020 Mar 6.
To determine factors associated with early (same-day) versus late (> 1 day) discharge of male patients following urethroplasty, and to compare short-term (30-day) postoperative morbidity and mortality across the two groups.
Using the National Surgical Quality Improvement Program database (2005-2016), patients who underwent urethroplasty with same-day hospital discharge (early) and those who stayed > 1 day (late) were identified. Extracted data included patient characteristics, comorbidities, preoperative labs, and 30-day postoperative complications. Multivariable logistic regressions determined factors associated with early (vs. late) discharge and the likelihood of having a complication in those who were discharged early (vs. late). Adjusted odds ratios and 95% CIs were reported.
N = 1435 male urethroplasty patients were identified, of which 396 (27.6%) were discharged early and 1039 (72.4%) were discharged late. White race (OR [95% CI]: 2.21 [1.44, 3.38]), urethroplasty performed in/after year 2011 (4.23 [2.51, 7.15]), and anterior (vs. posterior) urethroplasty without tissue transfer (1.65 [1.17, 2.34]) were significantly associated with increased likelihood of early discharge. However, every 10-min increase in operation time (0.88 [0.86, 0.90]) decreased the odds of early discharge. When short-term postoperative complications were compared between the two groups, patients discharged early had a lower likelihood of being readmitted (0.35 [0.14, 0.88]) compared to those discharged late. Rates of mortality, complications, or reoperation were similar between the groups.
Predictors of early discharge following urethroplasty include shorter operating time, white race, and having an anterior (vs. posterior) urethroplasty without tissue transfer. Patients discharged early had a lower likelihood of being readmitted.
确定与男性尿道成形术后早期（当日）与晚期（＞1 天）出院相关的因素，并比较两组患者的短期（30 天）术后发病率和死亡率。
使用国家手术质量改进计划数据库（2005-2016 年），确定当日出院（早期）和住院＞1 天（晚期）的患者。提取的数据包括患者特征、合并症、术前实验室检查和 30 天术后并发症。多变量逻辑回归确定与早期（vs. 晚期）出院相关的因素，以及早期（vs. 晚期）出院患者发生并发症的可能性。报告调整后的优势比和 95%置信区间。
共确定了 1435 名男性尿道成形术患者，其中 396 名（27.6%）患者早期出院，1039 名（72.4%）患者晚期出院。白人种族（比值比[95%CI]：2.21[1.44，3.38]）、2011 年及以后进行的尿道成形术（4.23[2.51，7.15]）和无组织转移的前（vs. 后）尿道成形术（1.65[1.17，2.34]）与早期出院的可能性增加显著相关。然而，手术时间每增加 10 分钟（0.88[0.86，0.90]），早期出院的可能性就会降低。比较两组患者的短期术后并发症，早期出院的患者再次入院的可能性较低（0.35[0.14，0.88]）。两组患者的死亡率、并发症发生率或再次手术率相似。
尿道成形术后早期出院的预测因素包括手术时间较短、白人种族以及无组织转移的前（vs. 后）尿道成形术。早期出院的患者再次入院的可能性较低。
