Complication and Readmission Rates following Same-Day Discharge after Percutaneous Renal Tumor Ablation

J Vasc Interv Radiol. 2016 Jan;27(1):80-6. doi: 10.1016/j.jvir.2015.09.007. Epub 2015 Nov 4.

Abstract

Purpose: To evaluate readmission rate and complications in patients undergoing same-day discharge following percutaneous thermal ablation of renal tumors.

Materials and methods: Patients undergoing same-day discharge following thermal ablation of renal tumors were reviewed. The primary outcome was the rate of readmission within 30 days of same-day discharge. The secondary outcomes included the rate and clinical outcomes of periprocedural complications.

Results: Same-day discharge occurred in 166/174 patients (95%), of whom 2/166 (1%) required short-term readmission due to pulmonary embolism and acute-on-chronic kidney injury. Both patients recovered without permanent morbidity. Admission due to complications occurred in 8/174 (5%) cases, the majority of which were related to hemorrhage. No significant differences in rates of complications or admission were found between cryoablation and RF ablation. Major complications (Clavien-Dindo grade II or higher, SIR grade C or higher) occurred in 7/174 (4%) cases, the majority related to hemorrhage. All cases were detected in the standard 4 hour postprocedural observation period and managed conservatively. The mean hemorrhage volume was significantly larger in patients requiring admission versus those discharged the same day (289 mL vs 34 mL; P = .02). Higher-volume hemorrhage occurred in larger tumors (mean, 4.0 cm vs 3.0 cm; P = .04). There was no association between major complications and central tumor or age.

Conclusions: Routine same-day discharge following percutaneous renal tumor thermal ablation can be performed with a low rate of short-term readmission. The majority of periprocedural complications can be managed conservatively, and patients can be discharged the same day.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cryosurgery*
  • Female
  • Humans
  • Kidney / surgery
  • Kidney Neoplasms / surgery*
  • Male
  • Middle Aged
  • Patient Discharge / statistics & numerical data*
  • Patient Readmission / statistics & numerical data*
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index