MP42-20 SAFETY AND FEASIBILITY OF NEXT-DAY DISCHARGE FOR MINIMALLY-INVASIVE PARTIAL NEPHRECTOMY - A NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM STUDY

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV1 Apr 2018MP42-20 SAFETY AND FEASIBILITY OF NEXT-DAY DISCHARGE FOR MINIMALLY-INVASIVE PARTIAL NEPHRECTOMY - A NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM STUDY Leilei Xia, Raju Chelluri, Ian Berger, Benjamin Taylor, Jose Pulido, and Thomas Guzzo Leilei XiaLeilei Xia More articles by this author , Raju ChelluriRaju Chelluri More articles by this author , Ian BergerIan Berger More articles by this author , Benjamin TaylorBenjamin Taylor More articles by this author , Jose PulidoJose Pulido More articles by this author , and Thomas GuzzoThomas Guzzo More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1327AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The widespread adoption of minimally-invasive partial nephrectomy (MIPN) for small renal masses has shortened hospital stays and improved convalescence. However, there is concern that patients being discharged home too quickly may compromise safety and increase readmissions. The objective is to assess whether next-day discharge (ND) (length of stay [LOS] 1 day) is associated with increased 30-day complications, reoperations, and readmissions compared with standard discharge (SD) (LOS 2-3 days). METHODS The National Surgical Quality Improvement Program (NSQIP) database (2012-2014) was used to identify all patients who underwent elective MIPN with a postoperative LOS of 1-3 days. We included patients who were admitted from home and discharged to home and did not have disseminated cancer, preoperative sepsis, or concurrent procedures. Cases with missing data were excluded. Demographics, perioperative characteristics, and adverse events were compared between the ND and SD groups. Multivariable logistic regression models adjusting for demographics and operative time were used to assess the independent predictors on 30-day overall complication, reoperation, and readmission rates. RESULTS A total of 2,024 patients were included (ND group, n=510 [25.2%]; SD group, n=1,514 [74.8%]). More subjects were female, had bleeding disorders, and underwent longer operative times in the SD group. Overall 30-day complication rates were low in both groups (ND, 3.3% vs. SD, 3.6%). There were no significant differences in adverse events, reoperations, and readmissions between the ND and SD groups (table). Multivariable logistic regression showed that ND was not associated with increased overall complications (odds ratio [OR]= 1.06, 95% confidence interval [CI]= 0.60-1.88, P=0.836), reoperations (OR=0.95, 95%CI=0.33-2.72, P=0.925), or readmissions (OR=0.92, 95%CI=0.50-1.68, P=0.784). CONCLUSIONS Next day discharge after MIPN was not associated with more complications, reoperations, or readmissions compared to standard discharge. While selection bias and surgeon preference may influence the timing of discharge, these results suggest next day discharge is feasible and can be safe. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e545 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Leilei Xia More articles by this author Raju Chelluri More articles by this author Ian Berger More articles by this author Benjamin Taylor More articles by this author Jose Pulido More articles by this author Thomas Guzzo More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...