Evaluation of factors and short-term postoperative morbidity associated with early versus late discharge following urethroplasty.

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.