Comparison of readmission and short-term mortality rates between different types of urinary diversion in patients undergoing radical cystectomy

Bruno Nahar, Tulay Sengul, Feng Miao, Nachiketh Soodana Prakash, Vivek Venkatramani, Aliyah Gauri, David Alonzo, Mahmoud Alameddine, Sanjaya Swain, Sanoj Punnen, Chad Ritch, Dipen J Parekh, Mark L Gonzalgo

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: To analyze the impact of urinary diversion type following radical cystectomy (RC) on readmission and short-term mortality rates. Methods: Patients who underwent RC for bladder cancer in the National Cancer Data Base were grouped based on the type of urinary diversion performed: non-continent [ileal conduit (IC)] or two continent techniques [continent pouch (CP) and orthotopic neobladder (NB)]. We used propensity score matching and multivariable logistic regression models to compare 30-day readmission and 30- and 90-day mortality between the different types of urinary diversion. Results: Among 11,933 patients who underwent RC, we identified 10,197 (85.5%) IC, 1044 (8.7%) CP, and 692 (5.8%) NB. Patients who received IC were significantly older and had more comorbidities (p < 0.0001). Continent diversions were more likely to be performed at an academic center (p < 0.0001). Surgery performed at a non-academic center was an independent predictor of 30-day readmission (OR 1.19, p = 0.010) and 30-day mortality (OR 1.27, p = 0.043). Patients undergoing NB had an increased likelihood of being readmitted (OR 1.41, p = 0.010). There was no significant difference in short-term mortality between groups. Conclusions: Patients undergoing NB had marginally increased rates of readmission compared to IC. Surgery performed at a non-academic center was associated with higher readmission and 30-day mortality. Similar short-term mortality rates were observed among the different types of urinary diversion.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalWorld Journal of Urology
DOIs
StateAccepted/In press - Dec 11 2017

Fingerprint

Urinary Diversion
Cystectomy
Mortality
Logistic Models
Propensity Score
Urinary Bladder Neoplasms
Comorbidity
Databases

Keywords

  • Cystectomy
  • Mortality
  • NCDB
  • Readmission
  • Urinary diversion

ASJC Scopus subject areas

  • Urology

Cite this

Comparison of readmission and short-term mortality rates between different types of urinary diversion in patients undergoing radical cystectomy. / Nahar, Bruno; Sengul, Tulay; Miao, Feng; Prakash, Nachiketh Soodana; Venkatramani, Vivek; Gauri, Aliyah; Alonzo, David; Alameddine, Mahmoud; Swain, Sanjaya; Punnen, Sanoj; Ritch, Chad; Parekh, Dipen J; Gonzalgo, Mark L.

In: World Journal of Urology, 11.12.2017, p. 1-7.

Research output: Contribution to journalArticle

Nahar, Bruno ; Sengul, Tulay ; Miao, Feng ; Prakash, Nachiketh Soodana ; Venkatramani, Vivek ; Gauri, Aliyah ; Alonzo, David ; Alameddine, Mahmoud ; Swain, Sanjaya ; Punnen, Sanoj ; Ritch, Chad ; Parekh, Dipen J ; Gonzalgo, Mark L. / Comparison of readmission and short-term mortality rates between different types of urinary diversion in patients undergoing radical cystectomy. In: World Journal of Urology. 2017 ; pp. 1-7.
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T1 - Comparison of readmission and short-term mortality rates between different types of urinary diversion in patients undergoing radical cystectomy

AU - Nahar, Bruno

AU - Sengul, Tulay

AU - Miao, Feng

AU - Prakash, Nachiketh Soodana

AU - Venkatramani, Vivek

AU - Gauri, Aliyah

AU - Alonzo, David

AU - Alameddine, Mahmoud

AU - Swain, Sanjaya

AU - Punnen, Sanoj

AU - Ritch, Chad

AU - Parekh, Dipen J

AU - Gonzalgo, Mark L

PY - 2017/12/11

Y1 - 2017/12/11

N2 - Purpose: To analyze the impact of urinary diversion type following radical cystectomy (RC) on readmission and short-term mortality rates. Methods: Patients who underwent RC for bladder cancer in the National Cancer Data Base were grouped based on the type of urinary diversion performed: non-continent [ileal conduit (IC)] or two continent techniques [continent pouch (CP) and orthotopic neobladder (NB)]. We used propensity score matching and multivariable logistic regression models to compare 30-day readmission and 30- and 90-day mortality between the different types of urinary diversion. Results: Among 11,933 patients who underwent RC, we identified 10,197 (85.5%) IC, 1044 (8.7%) CP, and 692 (5.8%) NB. Patients who received IC were significantly older and had more comorbidities (p < 0.0001). Continent diversions were more likely to be performed at an academic center (p < 0.0001). Surgery performed at a non-academic center was an independent predictor of 30-day readmission (OR 1.19, p = 0.010) and 30-day mortality (OR 1.27, p = 0.043). Patients undergoing NB had an increased likelihood of being readmitted (OR 1.41, p = 0.010). There was no significant difference in short-term mortality between groups. Conclusions: Patients undergoing NB had marginally increased rates of readmission compared to IC. Surgery performed at a non-academic center was associated with higher readmission and 30-day mortality. Similar short-term mortality rates were observed among the different types of urinary diversion.

AB - Purpose: To analyze the impact of urinary diversion type following radical cystectomy (RC) on readmission and short-term mortality rates. Methods: Patients who underwent RC for bladder cancer in the National Cancer Data Base were grouped based on the type of urinary diversion performed: non-continent [ileal conduit (IC)] or two continent techniques [continent pouch (CP) and orthotopic neobladder (NB)]. We used propensity score matching and multivariable logistic regression models to compare 30-day readmission and 30- and 90-day mortality between the different types of urinary diversion. Results: Among 11,933 patients who underwent RC, we identified 10,197 (85.5%) IC, 1044 (8.7%) CP, and 692 (5.8%) NB. Patients who received IC were significantly older and had more comorbidities (p < 0.0001). Continent diversions were more likely to be performed at an academic center (p < 0.0001). Surgery performed at a non-academic center was an independent predictor of 30-day readmission (OR 1.19, p = 0.010) and 30-day mortality (OR 1.27, p = 0.043). Patients undergoing NB had an increased likelihood of being readmitted (OR 1.41, p = 0.010). There was no significant difference in short-term mortality between groups. Conclusions: Patients undergoing NB had marginally increased rates of readmission compared to IC. Surgery performed at a non-academic center was associated with higher readmission and 30-day mortality. Similar short-term mortality rates were observed among the different types of urinary diversion.

KW - Cystectomy

KW - Mortality

KW - NCDB

KW - Readmission

KW - Urinary diversion

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