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Preoperative predictors of prolonged length of stay in radical cystectomy: a retrospective study using the American College of Surgeons-National Surgical Quality Improvement Program Dataset

BACKGROUND: Radical cystectomy (RC) is considered a complex procedure that entails significant morbidity and mortality. OBJECTIVES: We aimed to determine pre-operative patient characteristics that help predict a prolonged length of hospital stay (PLOS) following RC. DESIGN AND METHODS: The American...

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Autores principales: Abou Chawareb, Elia, Ayoub, Christian Habib, Najdi, Jad, Ghoubaira, Joseph, El-Hajj, Albert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10413889/
https://www.ncbi.nlm.nih.gov/pubmed/37577029
http://dx.doi.org/10.1177/17562872231191654
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author Abou Chawareb, Elia
Ayoub, Christian Habib
Najdi, Jad
Ghoubaira, Joseph
El-Hajj, Albert
author_facet Abou Chawareb, Elia
Ayoub, Christian Habib
Najdi, Jad
Ghoubaira, Joseph
El-Hajj, Albert
author_sort Abou Chawareb, Elia
collection PubMed
description BACKGROUND: Radical cystectomy (RC) is considered a complex procedure that entails significant morbidity and mortality. OBJECTIVES: We aimed to determine pre-operative patient characteristics that help predict a prolonged length of hospital stay (PLOS) following RC. DESIGN AND METHODS: The American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database was used to select patients who underwent RC between the years 2011 and 2020. Prolonged length of stay was defined as a hospital stay ⩾9 days. We compared patient demographics, pre-operative labs, surgical characteristics, and medical history between patients with or without PLOS. Multivariable logistic regression models controlling for pre-operative characteristics and propensity score matching for post-operative complications were conducted to control for possible confounders. RESULTS: The analysis yielded details of 19,158 RC patients of which 6007 (31%) patients had a PLOS. Patients with PLOS were more likely to have post-operative complications that could serve as predictors for the PLOS rather than their pre-operative characteristics. Hence, we matched our cohort for these complications. After matching, patient pre-operative characteristics that predict PLOS included female gender (Odds Ratio (OR) = 5.91), 10-year increase in age (OR = 1.15), non-White race (OR = 1.98), partially or totally dependent functional health status (OR = 2.86), bleeding disorders (OR = 4.67), congestive heart failure (OR = 1.59), pre-operative transfusion (OR = 3.03), and a 20-min increase in operative time (OR = 1.01) (p < 0.046). CONCLUSION: Patient demographics and pre-operative factors can help predict PLOS in RC patients. These predictors could serve as tools for patient counseling and risk stratification.
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spelling pubmed-104138892023-08-11 Preoperative predictors of prolonged length of stay in radical cystectomy: a retrospective study using the American College of Surgeons-National Surgical Quality Improvement Program Dataset Abou Chawareb, Elia Ayoub, Christian Habib Najdi, Jad Ghoubaira, Joseph El-Hajj, Albert Ther Adv Urol Original Research BACKGROUND: Radical cystectomy (RC) is considered a complex procedure that entails significant morbidity and mortality. OBJECTIVES: We aimed to determine pre-operative patient characteristics that help predict a prolonged length of hospital stay (PLOS) following RC. DESIGN AND METHODS: The American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database was used to select patients who underwent RC between the years 2011 and 2020. Prolonged length of stay was defined as a hospital stay ⩾9 days. We compared patient demographics, pre-operative labs, surgical characteristics, and medical history between patients with or without PLOS. Multivariable logistic regression models controlling for pre-operative characteristics and propensity score matching for post-operative complications were conducted to control for possible confounders. RESULTS: The analysis yielded details of 19,158 RC patients of which 6007 (31%) patients had a PLOS. Patients with PLOS were more likely to have post-operative complications that could serve as predictors for the PLOS rather than their pre-operative characteristics. Hence, we matched our cohort for these complications. After matching, patient pre-operative characteristics that predict PLOS included female gender (Odds Ratio (OR) = 5.91), 10-year increase in age (OR = 1.15), non-White race (OR = 1.98), partially or totally dependent functional health status (OR = 2.86), bleeding disorders (OR = 4.67), congestive heart failure (OR = 1.59), pre-operative transfusion (OR = 3.03), and a 20-min increase in operative time (OR = 1.01) (p < 0.046). CONCLUSION: Patient demographics and pre-operative factors can help predict PLOS in RC patients. These predictors could serve as tools for patient counseling and risk stratification. SAGE Publications 2023-08-10 /pmc/articles/PMC10413889/ /pubmed/37577029 http://dx.doi.org/10.1177/17562872231191654 Text en © The Author(s), 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Abou Chawareb, Elia
Ayoub, Christian Habib
Najdi, Jad
Ghoubaira, Joseph
El-Hajj, Albert
Preoperative predictors of prolonged length of stay in radical cystectomy: a retrospective study using the American College of Surgeons-National Surgical Quality Improvement Program Dataset
title Preoperative predictors of prolonged length of stay in radical cystectomy: a retrospective study using the American College of Surgeons-National Surgical Quality Improvement Program Dataset
title_full Preoperative predictors of prolonged length of stay in radical cystectomy: a retrospective study using the American College of Surgeons-National Surgical Quality Improvement Program Dataset
title_fullStr Preoperative predictors of prolonged length of stay in radical cystectomy: a retrospective study using the American College of Surgeons-National Surgical Quality Improvement Program Dataset
title_full_unstemmed Preoperative predictors of prolonged length of stay in radical cystectomy: a retrospective study using the American College of Surgeons-National Surgical Quality Improvement Program Dataset
title_short Preoperative predictors of prolonged length of stay in radical cystectomy: a retrospective study using the American College of Surgeons-National Surgical Quality Improvement Program Dataset
title_sort preoperative predictors of prolonged length of stay in radical cystectomy: a retrospective study using the american college of surgeons-national surgical quality improvement program dataset
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10413889/
https://www.ncbi.nlm.nih.gov/pubmed/37577029
http://dx.doi.org/10.1177/17562872231191654
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