Mp12-16 National Trends in Same Day Discharge for Radical Prostatectomy: An Evolution in Practice Patterns

You have accessJournal of UrologyHealth Services Research: Practice Patterns, Quality of Life and Shared Decision Making I (MP12) 1 May 2024MP12-16 NATIONAL TRENDS IN SAME DAY DISCHARGE FOR RADICAL PROSTATECTOMY: AN EVOLUTION IN PRACTICE PATTERNS Grant M. Henning, Ekamjit S. Deol, Spyridon P. Basourakos, Ranveer M. Vasdev, Matthew K. Tollefson, Igor Frank, Paras Shah, Abhinav Khanna, R. Houston Thompson, R. Jeffrey Karnes, Stephen A. Boorjian, and Vidit Sharma Grant M. HenningGrant M. Henning, Ekamjit S. DeolEkamjit S. Deol, Spyridon P. BasourakosSpyridon P. Basourakos, Ranveer M. VasdevRanveer M. Vasdev, Matthew K. TollefsonMatthew K. Tollefson, Igor FrankIgor Frank, Paras ShahParas Shah, Abhinav KhannaAbhinav Khanna, R. Houston ThompsonR. Houston Thompson, R. Jeffrey KarnesR. Jeffrey Karnes, Stephen A. BoorjianStephen A. Boorjian, and Vidit SharmaVidit Sharma View All Author Informationhttps: //doi. org/10. 1097/01. JU. 0001009376. 16371. fb. 16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Interest has grown in optimizing radical prostatectomy (RP) pathways for treatment of prostate cancer (PCa). Historically requiring inpatient services, the safety of same day discharge (SDD) for RP has been recently established. We aim to determine national trends in SDD for RP. METHODS: A retrospective analysis was performed using the National Inpatient Survey (NIS) database. Cases were identified using ICD-10 procedure codes for RP in patients with a primary diagnosis of PCa between 2016-2020. Admission and discharge dates were used to identify patients who had SDD. We queried the database for factors associated with SDD. Annual hospital caseload (AHC) was categorized into quartiles. Trends in SDD were analyzed and logistic regression analysis was performed for factors associated with SDD. Multivariable linear regression was performed to analyze total hospital charges. All data was weighted to a national average using NIS guidelines. RESULTS: 271, 560 eligible RPs were identified using weighted estimates from 2016-2020. Over the study period, there was an upward trend in SDD with 3. 5% of patients having SDD in 2020, compared to 0. 6% in 2016. When stratified by AHC, this trend was primarily driven by hospitals with the highest caseloads with rate of SDD increasing from 0. 6% in 2016 to 4. 2% in 2020 (Figure 1). On univariable analysis, SDD was associated with a 5349 reduction in hospital charges (p=0. 047). On multivariable analysis, minimally invasive surgical approach (OR 1. 61, p<0. 01) and high ACH (OR 3. 85, p<0. 01) demonstrated significant association with SDD. On interaction analysis, hospital bedsize showed a moderating effect (OR 0. 64, p=0. 03) on the association between ACH and SDD, such that larger bedsize hospitals had lower odds of SDD for a given ACH. CONCLUSIONS: Utilization of SDD for RP has expanded considerably with 3. 5% of patients having SDD in 2020 compared to 0. 6% in 2016. This appears driven primarily by hospitals with the highest caseloads. While continuation of this trend is likely to have favorable impact on hospital bed utilization, further definition of optimal care pathways is needed prior to widespread implementation. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc. FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e207 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc. Metrics Author Information Grant M. Henning More articles by this author Ekamjit S. Deol More articles by this author Spyridon P. Basourakos More articles by this author Ranveer M. Vasdev More articles by this author Matthew K. Tollefson More articles by this author Igor Frank More articles by this author Paras Shah More articles by this author Abhinav Khanna More articles by this author R. Houston Thompson More articles by this author R. Jeffrey Karnes More articles by this author Stephen A. Boorjian More articles by this author Vidit Sharma More articles by this author Expand All Advertisement PDF downloadLoading. . .