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 language | English (US) |
|---|---|
| Pages (from-to) | 1-7 |
| Number of pages | 7 |
| Journal | World Journal of Urology |
| DOIs | |
| State | Accepted/In press - Dec 11 2017 |
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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 journal › Article
}
TY - JOUR
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
UR - http://www.scopus.com/inward/record.url?scp=85037676023&partnerID=8YFLogxK
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U2 - 10.1007/s00345-017-2140-3
DO - 10.1007/s00345-017-2140-3
M3 - Article
SP - 1
EP - 7
JO - World Journal of Urology
JF - World Journal of Urology
SN - 0724-4983
ER -