Comparison of readmission and short-term mortality rates between different types of urinary diversion in patients undergoing radical cystectomy.
World J Urol
; 36(3): 393-399, 2018 Mar.
Article
en En
| MEDLINE
| ID: mdl-29230495
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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Readmisión del Paciente
/
Derivación Urinaria
/
Neoplasias de la Vejiga Urinaria
/
Carcinoma de Células Transicionales
/
Cistectomía
/
Mortalidad
Tipo de estudio:
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
World J Urol
Año:
2018
Tipo del documento:
Article
País de afiliación:
Estados Unidos