Presentation Authors: Olamide Omidele*, New York, NY, Mark Finkelstein, Khawaja Bilal, Michael Palese, New York , NY
Introduction: This study analyzes trends and etiologies in 30-day readmission rates for major urological procedures, specifically radical prostatectomy (RP), radical nephrectomy (RN), and partial nephrectomy (PN).
Methods: We utilized the New York Statewide Planning and Research Cooperative System (SPARCS) database from 2006 to 2015 to identify all RP (ICD-9: 60.5), RN (ICD-9: 55.5), and all PN (ICD-9: 55.4). Minimally invasive surgery (MIS) was identified using the laparoscopic modifier (ICD-9: 54.21). Patient level data was collected for all patients who were readmitted during the first 30 days after discharge and trends were compared.
Results: The 30-day readmission rate for open RP was 864 (4%) compared to 1013 (4%) for MIS RP (p < .001). The 30-day readmission rate for open RN was 2184 (12%) compared to 509 (9%) for MIS RN (p < .001). The 30-day readmission rate for open PN was 781 (8%) compared to 376 (6%) for MIS PN (p < .001). The major etiology of 30-day readmission was genitourinary in nature for PN and gastrointestinal in nature for both RN and RP (p < .001). The difference in 30-day readmission from the start of the study to the end decreased by 1.4% for RN (p = 0.075), and 2.2% for PN (p = 0.003). It increased by 0.1% for RP (p = 0.727). Significance was noted for a decrease in MIS readmission rates for PN of 3.6% (p < .001) and RP of 2.4% (p=0.014). Significance was noted for an increase in readmission rates for open RP of 2.4% (p < .001).
Conclusions: The study suggests that MIS approach is associated with decreased length of stay, increased home discharge, and lower 30-day readmission rates. Trends suggests that 30-day readmission rates are decreasing over time, largely due to improvements in 30-day readmission by MIS approaches.