USC Institute of Urology, Keck Medicine of USC, University of Southern California, Los Angeles, California.
J Urol. 2021 Feb;205(2):491-499. doi: 10.1097/JU.0000000000001387. Epub 2020 Oct 9.
We examine the timing, patterns and predictors of 90-day readmission after robotic radical cystectomy.
From September 2009 to March 2017, 271 consecutive patients undergoing robotic radical cystectomy with intent to cure bladder cancer (intracorporeal diversion 253, 93%) were identified from our prospectively collated institutional database. Readmission was defined as any subsequent inpatient admission or unplanned visit occurring within 90 days from discharge after the index hospitalization. Multiple readmissions were defined as 2 or more readmissions within a 90-day period. Logistic regression analysis was used to identify independent factors related to single and multiple 90-day readmissions.
A total of 78 (28.8%) patients were readmitted at least once within 90 days after discharge, of whom 20 (25.6%) reported multiple readmissions. The cumulative duration of readmission was 6.2 (6.17) days with 6 (7.6%) patients having less than 24 hours readmission. Metabolic, infectious, genitourinary and gastrointestinal complications were identified as the primary cause of readmission in 39.5%, 23.5%, 22.3% and 17%, respectively. Fifty percent of readmissions occurred in the first 2 weeks after hospital discharge. On multivariable logistic regression analysis in-hospital infections (OR 2.85, p=0.001) were independent predictors for overall readmission. Male gender (OR 3.5, p=0.02) and in-hospital infections (OR 4.35, p=0.002) were independent predictors for multiple readmissions.
The 90-day readmission rate following robotic radical cystectomy is significant. In-hospital infections and male gender were independent factors for readmission. Most readmissions occurred in the first 2 weeks following discharge, with metabolic derangements and infections being the most common causes.
我们研究了机器人根治性膀胱切除术 90 天后再入院的时间、模式和预测因素。
从 2009 年 9 月至 2017 年 3 月，从我们前瞻性收集的机构数据库中确定了 271 例连续接受机器人根治性膀胱切除术治疗膀胱癌（253 例为体内分流术，93%）的患者。再入院定义为出院后 90 天内任何随后的住院或计划外就诊。多次再入院定义为在 90 天内有 2 次或更多次再入院。使用逻辑回归分析确定与单次和多次 90 天再入院相关的独立因素。
共有 78 例（28.8%）患者在出院后 90 天内至少再入院一次，其中 20 例（25.6%）报告多次再入院。再入院的累计持续时间为 6.2（6.17）天，有 6 例（7.6%）患者的再入院时间少于 24 小时。代谢、感染、泌尿生殖和胃肠道并发症分别被确定为再入院的主要原因，占 39.5%、23.5%、22.3%和 17%。50%的再入院发生在出院后 2 周内。多变量逻辑回归分析显示，院内感染（OR 2.85，p=0.001）是总再入院的独立预测因素。男性（OR 3.5，p=0.02）和院内感染（OR 4.35，p=0.002）是多次再入院的独立预测因素。
机器人根治性膀胱切除术后 90 天再入院率较高。院内感染和男性是再入院的独立因素。大多数再入院发生在出院后 2 周内，以代谢紊乱和感染最为常见。
