Comparison of readmission and short-term mortality rates between different types of urinary diversion in patients undergoing radical cystectomy

Bruno Nahar, Tulay Koru-Sengul, Feng Miao, Nachiketh Soodana Prakash, Vivek Venkatramani, Aliyah Gauri, David Alonzo, Mahmoud Alameddine, Sanjaya Swain, Sanoj Punnen, Chad Ritch, Dipen J. Parekh, Mark L. Gonzalgo

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Purpose: To analyze the impact of urinary diversion type following radical cystectomy (RC) on readmission and short-term mortality rates. Methods: Patients who underwent RC for bladder cancer in the National Cancer Data Base were grouped based on the type of urinary diversion performed: non-continent [ileal conduit (IC)] or two continent techniques [continent pouch (CP) and orthotopic neobladder (NB)]. We used propensity score matching and multivariable logistic regression models to compare 30-day readmission and 30- and 90-day mortality between the different types of urinary diversion. Results: Among 11,933 patients who underwent RC, we identified 10,197 (85.5%) IC, 1044 (8.7%) CP, and 692 (5.8%) NB. Patients who received IC were significantly older and had more comorbidities (p < 0.0001). Continent diversions were more likely to be performed at an academic center (p < 0.0001). Surgery performed at a non-academic center was an independent predictor of 30-day readmission (OR 1.19, p = 0.010) and 30-day mortality (OR 1.27, p = 0.043). Patients undergoing NB had an increased likelihood of being readmitted (OR 1.41, p = 0.010). There was no significant difference in short-term mortality between groups. Conclusions: Patients undergoing NB had marginally increased rates of readmission compared to IC. Surgery performed at a non-academic center was associated with higher readmission and 30-day mortality. Similar short-term mortality rates were observed among the different types of urinary diversion.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalWorld Journal of Urology
DOIs
StateAccepted/In press - Dec 11 2017
Externally publishedYes

Keywords

  • Cystectomy
  • Mortality
  • NCDB
  • Readmission
  • Urinary diversion

ASJC Scopus subject areas

  • Urology

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    Nahar, B., Koru-Sengul, T., Miao, F., Prakash, N. S., Venkatramani, V., Gauri, A., Alonzo, D., Alameddine, M., Swain, S., Punnen, S., Ritch, C., Parekh, D. J., & Gonzalgo, M. L. (Accepted/In press). Comparison of readmission and short-term mortality rates between different types of urinary diversion in patients undergoing radical cystectomy. World Journal of Urology, 1-7. https://doi.org/10.1007/s00345-017-2140-3