Determining factors for hospital discharge status after radical cystectomy in a large contemporary cohort

Monty A. Aghazadeh, Daniel A. Barocas, Shady Salem, Peter E. Clark, Michael S. Cookson, Rodney Davis, Justin Gregg, C. J. Stimson, Joseph A. Smith, Sam S. Chang

Research output: Contribution to journalArticle

Abstract

Purpose We describe hospital discharge status in patients after radical cystectomy for bladder cancer. We determined factors affecting discharge status. Materials and Methods The 445 patients underwent radical cystectomy for urothelial carcinoma from January 2004 to December 2007. Patients were grouped by hospital discharge status into 1 of 4 groups, including home under self-care without services, home with home health services, subacute, rehabilitation or skilled nursing facility, or hospice/in-hospital mortality. We compared clinical, perioperative and pathological variables in these groups. We also examined the association of discharge status with the hospital readmission rate and 90-day mortality. Results Of the 440 patients 250 (56.8%), 145 (32.9%), 39 (8.9%) and 6 (1.4%) were in the home without services, home with services, facility and mortality groups, respectively. On multivariate analysis older age, lower preoperative albumin, unmarried status and higher Charlson comorbidity index were predictors of discharge home with services while older age, poor preoperative exercise tolerance and longer hospital stay predicted discharge to a facility. Patients in the facility group were more likely to die within 90 days of surgery than those who returned home independently or with services. There was no difference in the likelihood of rehospitalization. Conclusions Sociodemographic factors, preoperative performance status, and comorbidities and perioperative factors contribute to the discharge decision after radical cystectomy. Some subgroups can be predicted to have increased postoperative care needs and may be appropriate targets for disposition planning preoperatively.

Original languageEnglish (US)
Pages (from-to)85-89
Number of pages5
JournalJournal of Urology
Volume185
Issue number1
DOIs
StatePublished - Jan 2011
Externally publishedYes

Fingerprint

Cystectomy
Comorbidity
Skilled Nursing Facilities
Group Homes
Patient Readmission
Hospices
Exercise Tolerance
Mortality
Postoperative Care
Self Care
Hospital Mortality
Ambulatory Surgical Procedures
Urinary Bladder Neoplasms
Health Services
Albumins
Length of Stay
Rehabilitation
Multivariate Analysis
Carcinoma

Keywords

  • Bladder neoplasms
  • Cystectomy
  • Patient discharge
  • Postoperative care
  • Urinary bladder

ASJC Scopus subject areas

  • Urology

Cite this

Aghazadeh, M. A., Barocas, D. A., Salem, S., Clark, P. E., Cookson, M. S., Davis, R., ... Chang, S. S. (2011). Determining factors for hospital discharge status after radical cystectomy in a large contemporary cohort. Journal of Urology, 185(1), 85-89. https://doi.org/10.1016/j.juro.2010.08.016

Determining factors for hospital discharge status after radical cystectomy in a large contemporary cohort. / Aghazadeh, Monty A.; Barocas, Daniel A.; Salem, Shady; Clark, Peter E.; Cookson, Michael S.; Davis, Rodney; Gregg, Justin; Stimson, C. J.; Smith, Joseph A.; Chang, Sam S.

In: Journal of Urology, Vol. 185, No. 1, 01.2011, p. 85-89.

Research output: Contribution to journalArticle

Aghazadeh, MA, Barocas, DA, Salem, S, Clark, PE, Cookson, MS, Davis, R, Gregg, J, Stimson, CJ, Smith, JA & Chang, SS 2011, 'Determining factors for hospital discharge status after radical cystectomy in a large contemporary cohort', Journal of Urology, vol. 185, no. 1, pp. 85-89. https://doi.org/10.1016/j.juro.2010.08.016
Aghazadeh, Monty A. ; Barocas, Daniel A. ; Salem, Shady ; Clark, Peter E. ; Cookson, Michael S. ; Davis, Rodney ; Gregg, Justin ; Stimson, C. J. ; Smith, Joseph A. ; Chang, Sam S. / Determining factors for hospital discharge status after radical cystectomy in a large contemporary cohort. In: Journal of Urology. 2011 ; Vol. 185, No. 1. pp. 85-89.
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