Study identifies predictors of discharge following cystectomy

Predictors of discharge status after radical cystectomy include sociodemographic factors, preoperative performance status, comorbidities, and perioperative factors, say researchers from Vanderbilt University, Nashville, TN.

First author Monty A. Aghazadeh, MD, and colleagues analyzed discharge status in 445 patients who had undergone cystectomy between January 2004 and December 2007. Patients were grouped into one of four groups based on discharge status: home without services, home with services, facility, and mortality groups. Clinical, perioperative, and pathologic variables were compared, as was the association of discharge status with the hospital re-admission rate and 90-day mortality.

The team determined that older age, lower preoperative albumin, unmarried status, and more comorbidities predicted discharge at home with services, whereas older age, poor preoperative exercise tolerance, and longer hospital stay predicted discharge to a facility. They further found that 20.5% of patients discharged to a facility died within 90 days of surgery, compared with 4.8% and 4% of those discharged at home with and without services, respectively. There was no difference in the rate of re-hospitalization among the groups.

"Some subgroups can be predicted to have increased postoperative care needs and may be appropriate targets for disposition planning preoperatively," the authors, led by Sam S. Chang, MD, wrote in the Journal of Urology (2011; 185:85-9).