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

Int Braz J Urol. 2018 Nov-Dec;44(6):1089-1105. doi: 10.1590/S1677-5538.IBJU.2017.0339.

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: Prostatectomy; Retrospective Studies; Therapeutics.

MeSH terms

  • Aged
  • Hospitals, High-Volume / statistics & numerical data*
  • Humans
  • Length of Stay / statistics & numerical data*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Postoperative Complications*
  • Prostatectomy* / adverse effects
  • Prostatectomy* / methods
  • Prostatic Neoplasms / surgery*
  • Retrospective Studies
  • Risk Factors