Hospitalization before surgery and subsequent risk of infective complications after radical cystectomy: A population-based analysis

E Zaffuto, R Pompe, HD Bondarenko, M Moschini, P Dell'Oglio, G Gandaglia, Nicola Fossati, SF Shariat, F Montorsi, A Briganti, PI Karakiewicz

Research output: Contribution to journalArticle

Abstract

Introduction: The length of stay prior to surgery increases the risk of postoperative infections (PIs) in several surgical settings, such as cardiac, orthopedic, and general surgery. However, data for urological oncology procedures are limited. We examined PI rates after radical cystectomy (RC) according to the length of stay prior to RC (LOSPRC). Materials and methods: A total of 24,242 patients with bladder cancer treated with RC between 1998 and 2013 were abstracted from the National Inpatients Sample database. We evaluated changes over time in LOSPRC (0 vs. 1 vs. 2 days or more) and tested its effect on PI rates. Multivariable logistic regression analyses were adjusted for the year of surgery, sex, age, ethnicity, comorbidities, hospital location, teaching status, hospital surgical volume, and number of hospital beds. Results: Overall, 19,401 (80.0%), 3,990 (16.5%), and 851 (3.5%) individuals with LOSPRC of 0, 1. and 2 or more were identified. The proportion of LOSPRC 0 patients increased from 61.4% in 1998 to 91.0% in 2013 (P <0.001), whereas the opposite trend was observed for LOSPRC 1 and 2 or more. In multivariable logistic regression analyses predicting PIs, LOSPRC of 1 (odds ratio: 1.38; 95% CI: 1.25-1.53; P <0.001) and LOSPRC of 2 or more (odds ratio: 2.15; 95% CI: 1.81-2.55; P <0.001) achieved independent predictor status. Conclusions: A delay in surgery as short as 1 day significantly increases the risk of PIs after RC. In consequence, same day of admission surgery policies should be further promoted to reduce the risk of PIs. © 2017 Elsevier Inc.
Original languageEnglish
Pages (from-to)659.e7-659.e12
JournalUrologic Oncology: Seminars and Original Investigations
Volume35
Issue number11
DOIs
Publication statusPublished - 2017

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Cystectomy
Length of Stay
Hospitalization
Population
Infection
Logistic Models
Odds Ratio
Regression Analysis
Ambulatory Surgical Procedures
Urinary Bladder Neoplasms
Teaching Hospitals
Thoracic Surgery
Orthopedics
Comorbidity
Inpatients
Databases

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Hospitalization before surgery and subsequent risk of infective complications after radical cystectomy: A population-based analysis. / Zaffuto, E; Pompe, R; Bondarenko, HD; Moschini, M; Dell'Oglio, P; Gandaglia, G; Fossati, Nicola; Shariat, SF; Montorsi, F; Briganti, A; Karakiewicz, PI.

In: Urologic Oncology: Seminars and Original Investigations, Vol. 35, No. 11, 2017, p. 659.e7-659.e12.

Research output: Contribution to journalArticle

Zaffuto, E ; Pompe, R ; Bondarenko, HD ; Moschini, M ; Dell'Oglio, P ; Gandaglia, G ; Fossati, Nicola ; Shariat, SF ; Montorsi, F ; Briganti, A ; Karakiewicz, PI. / Hospitalization before surgery and subsequent risk of infective complications after radical cystectomy: A population-based analysis. In: Urologic Oncology: Seminars and Original Investigations. 2017 ; Vol. 35, No. 11. pp. 659.e7-659.e12.
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abstract = "Introduction: The length of stay prior to surgery increases the risk of postoperative infections (PIs) in several surgical settings, such as cardiac, orthopedic, and general surgery. However, data for urological oncology procedures are limited. We examined PI rates after radical cystectomy (RC) according to the length of stay prior to RC (LOSPRC). Materials and methods: A total of 24,242 patients with bladder cancer treated with RC between 1998 and 2013 were abstracted from the National Inpatients Sample database. We evaluated changes over time in LOSPRC (0 vs. 1 vs. 2 days or more) and tested its effect on PI rates. Multivariable logistic regression analyses were adjusted for the year of surgery, sex, age, ethnicity, comorbidities, hospital location, teaching status, hospital surgical volume, and number of hospital beds. Results: Overall, 19,401 (80.0{\%}), 3,990 (16.5{\%}), and 851 (3.5{\%}) individuals with LOSPRC of 0, 1. and 2 or more were identified. The proportion of LOSPRC 0 patients increased from 61.4{\%} in 1998 to 91.0{\%} in 2013 (P <0.001), whereas the opposite trend was observed for LOSPRC 1 and 2 or more. In multivariable logistic regression analyses predicting PIs, LOSPRC of 1 (odds ratio: 1.38; 95{\%} CI: 1.25-1.53; P <0.001) and LOSPRC of 2 or more (odds ratio: 2.15; 95{\%} CI: 1.81-2.55; P <0.001) achieved independent predictor status. Conclusions: A delay in surgery as short as 1 day significantly increases the risk of PIs after RC. In consequence, same day of admission surgery policies should be further promoted to reduce the risk of PIs. {\circledC} 2017 Elsevier Inc.",
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TY - JOUR

T1 - Hospitalization before surgery and subsequent risk of infective complications after radical cystectomy: A population-based analysis

AU - Zaffuto, E

AU - Pompe, R

AU - Bondarenko, HD

AU - Moschini, M

AU - Dell'Oglio, P

AU - Gandaglia, G

AU - Fossati, Nicola

AU - Shariat, SF

AU - Montorsi, F

AU - Briganti, A

AU - Karakiewicz, PI

PY - 2017

Y1 - 2017

N2 - Introduction: The length of stay prior to surgery increases the risk of postoperative infections (PIs) in several surgical settings, such as cardiac, orthopedic, and general surgery. However, data for urological oncology procedures are limited. We examined PI rates after radical cystectomy (RC) according to the length of stay prior to RC (LOSPRC). Materials and methods: A total of 24,242 patients with bladder cancer treated with RC between 1998 and 2013 were abstracted from the National Inpatients Sample database. We evaluated changes over time in LOSPRC (0 vs. 1 vs. 2 days or more) and tested its effect on PI rates. Multivariable logistic regression analyses were adjusted for the year of surgery, sex, age, ethnicity, comorbidities, hospital location, teaching status, hospital surgical volume, and number of hospital beds. Results: Overall, 19,401 (80.0%), 3,990 (16.5%), and 851 (3.5%) individuals with LOSPRC of 0, 1. and 2 or more were identified. The proportion of LOSPRC 0 patients increased from 61.4% in 1998 to 91.0% in 2013 (P <0.001), whereas the opposite trend was observed for LOSPRC 1 and 2 or more. In multivariable logistic regression analyses predicting PIs, LOSPRC of 1 (odds ratio: 1.38; 95% CI: 1.25-1.53; P <0.001) and LOSPRC of 2 or more (odds ratio: 2.15; 95% CI: 1.81-2.55; P <0.001) achieved independent predictor status. Conclusions: A delay in surgery as short as 1 day significantly increases the risk of PIs after RC. In consequence, same day of admission surgery policies should be further promoted to reduce the risk of PIs. © 2017 Elsevier Inc.

AB - Introduction: The length of stay prior to surgery increases the risk of postoperative infections (PIs) in several surgical settings, such as cardiac, orthopedic, and general surgery. However, data for urological oncology procedures are limited. We examined PI rates after radical cystectomy (RC) according to the length of stay prior to RC (LOSPRC). Materials and methods: A total of 24,242 patients with bladder cancer treated with RC between 1998 and 2013 were abstracted from the National Inpatients Sample database. We evaluated changes over time in LOSPRC (0 vs. 1 vs. 2 days or more) and tested its effect on PI rates. Multivariable logistic regression analyses were adjusted for the year of surgery, sex, age, ethnicity, comorbidities, hospital location, teaching status, hospital surgical volume, and number of hospital beds. Results: Overall, 19,401 (80.0%), 3,990 (16.5%), and 851 (3.5%) individuals with LOSPRC of 0, 1. and 2 or more were identified. The proportion of LOSPRC 0 patients increased from 61.4% in 1998 to 91.0% in 2013 (P <0.001), whereas the opposite trend was observed for LOSPRC 1 and 2 or more. In multivariable logistic regression analyses predicting PIs, LOSPRC of 1 (odds ratio: 1.38; 95% CI: 1.25-1.53; P <0.001) and LOSPRC of 2 or more (odds ratio: 2.15; 95% CI: 1.81-2.55; P <0.001) achieved independent predictor status. Conclusions: A delay in surgery as short as 1 day significantly increases the risk of PIs after RC. In consequence, same day of admission surgery policies should be further promoted to reduce the risk of PIs. © 2017 Elsevier Inc.

U2 - 10.1016/j.urolonc.2017.07.004

DO - 10.1016/j.urolonc.2017.07.004

M3 - Article

VL - 35

SP - 659.e7-659.e12

JO - Urologic Oncology

JF - Urologic Oncology

SN - 1078-1439

IS - 11

ER -