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11.12.2017 | Original Article

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

verfasst von: Bruno Nahar, Tulay Koru-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

Erschienen in: World Journal of Urology | Ausgabe 3/2018

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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.

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Titel: Comparison of readmission and short-term mortality rates between different types of urinary diversion in patients undergoing radical cystectomy
verfasst von: Bruno Nahar
Tulay Koru-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
Publikationsdatum: 11.12.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 3/2018
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-017-2140-3

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

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Purpose

Methods

Results

Conclusions

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