Predictive factors for prolonged hospital stay after retropubic radical prostatectomy in a high-volume teaching center

Vol. 44 (6): 1089-1105, November – December, 2018

doi: 10.1590/S1677-5538.IBJU.2017.0339


ORIGINAL ARTICLE

Rafael F. Coelho 1, Mauricio D. Cordeiro 1, Guilherme P. Padovani 1, Rafael Localli 1, Limirio Fonseca 1, José Pontes Junior 1, Giuliano B. Guglielmetti 1, Miguel Srougi 1, William Carlos Nahas 1
1 Divisão de Urologia, Instituto do Câncer de Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil

ABSTRACT

Objective: To evaluate the length hospital stay and predictors of prolonged hospitaliza­tion after RRP performed in a high-surgical volume teaching institution, and analyze the rate of unplanned visits to the office, emergency care, hospital readmissions and perioperative complications rates.

Materials and Methods: Retrospective analysis of prospectively collected data in a standardized database for patients with localized prostate cancer undergoing RRP in our institution between January/2010 – January/2012.

A logistic regression model including preoperative variables was initially built in order to determine the factors that predict prolonged hospital stay before the surgical pro­cedure; subsequently, a second model including both pre and intraoperative variables was analyzed.

Results: 1011 patients underwent RRP at our institution were evaluated. The median hospital stay was 2 days, and 217 (21.5%) patients had prolonged hospitalization. Predictors of prolonged hospital stay among the preoperative variables were ICC (OR. 1.40 p=0.003), age (OR 1.050 p<0.001), ASA score of 3 (OR. 3.260 p<0.001), pros­tate volume on USG-TR (OR, 1.005 p=0.038) and African-American race (OR 2.235 p=0.004); among intra and postoperative factors, operative time (OR 1.007 p=0.022) and the presence of any complications (OR 2.013 p=0.009) or major complications (OR 2.357 p=0.01) were also correlated independently with prolonged hospital stay. The complication rate was 14.5%.

Conclusions: The independent predictors of prolonged hospitalization among preop­erative variables were CCI, age, ASA score of 3, prostate volume on USG-TR and African-American race; amongst intra and postoperative factors, operative time, pres­ence of any complications and major complications were correlated independently with prolonged hospital stay.

Keywords: rostatectomy; Therapeutics; Retrospective Studies

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