Impact of Complications and hospital-free days on health related quality of life 1 year after radical cystectomy

Chad R. Ritch, Michael S. Cookson, Sam S. Chang, Peter E. Clark, Matthew J. Resnick, David F. Penson, Joseph A. Smith, Alex T. May, Christopher B. Anderson, Chaochen You, Haerin Lee, Daniel A. Barocas

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Purpose: We determined the extent to which complications as well as number of hospital-free days within 30 and 90 days of surgery predicted health related quality of life 1 year after radical cystectomy.

Materials and Methods: We used data from a prospective health related quality of life study using a validated instrument, the Vanderbilt Cystectomy Index-15. Complications were graded by the Clavien system, and hospital length of stay and length of stay during readmissions were used to calculate 30 and 90-day hospital-free days, respectively. We compared the number of hospital-free days among patients with varying levels of complications. Multivariate analysis was performed to determine predictors of Vanderbilt Cystectomy Index-15 score 1 year after surgery adjusting for demographic (age, gender, comorbidities) and clinical variables (stage and diversion type).

Results: A total of 100 patients with complete baseline and 1-year followup health related quality of life data were included in the analysis. Median (IQR) 30 and 90-day hospital-free days were 24 (22-25) and 84 (82-85), respectively. Patients who experienced any complications had significantly fewer 30-day hospital-free days (22 vs 24 days, p <0.01) and 90-day hospital-free days (81 vs 84 days, p <0.01), and patients with higher grade complications had fewer hospital-free days than those with lower grade or no complications (p <0.01). On multivariate analysis female gender and baseline Vanderbilt Cystectomy Index-15 score independently predicted higher 1-year health related quality of life scores.

Conclusions: Patients who experience complications after radical cystectomy have fewer 30 and 90-day hospital-free days. However, neither predicts health related quality of life at 1 year. Instead, long-term health related quality of life appears to be driven largely by baseline health related quality of life and gender.

Original languageEnglish (US)
Pages (from-to)1360-1364
Number of pages5
JournalJournal of Urology
Volume192
Issue number5
DOIs
StatePublished - Nov 1 2014
Externally publishedYes

Keywords

  • complications
  • cystectomy
  • length of stay
  • patient readmission
  • quality of life

ASJC Scopus subject areas

  • Urology

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    Ritch, C. R., Cookson, M. S., Chang, S. S., Clark, P. E., Resnick, M. J., Penson, D. F., Smith, J. A., May, A. T., Anderson, C. B., You, C., Lee, H., & Barocas, D. A. (2014). Impact of Complications and hospital-free days on health related quality of life 1 year after radical cystectomy. Journal of Urology, 192(5), 1360-1364. https://doi.org/10.1016/j.juro.2014.06.004