Mp33-09 Readmission After Radical Prostatectomy: Characterizing Timing and Etiology to Identify Quality Improvement Targets

You have accessJournal of UrologyHealth Services Research: Quality Improvement & Patient Safety II (MP33)1 May 2024MP33-09 READMISSION AFTER RADICAL PROSTATECTOMY: CHARACTERIZING TIMING AND ETIOLOGY TO IDENTIFY QUALITY IMPROVEMENT TARGETS Patrick Lewicki, Sabir Meah, Corinne Labardee, Anna Johnson, Ryan J. Nelson, James O. Peabody, Alice Semerjian, Kevin B. Ginsburg, Brian R. Lane, Tudor Borza, and for the Michigan Urological Surgery Improvement Collaborative Patrick LewickiPatrick Lewicki , Sabir MeahSabir Meah , Corinne LabardeeCorinne Labardee , Anna JohnsonAnna Johnson , Ryan J. NelsonRyan J. Nelson , James O. PeabodyJames O. Peabody , Alice SemerjianAlice Semerjian , Kevin B. GinsburgKevin B. Ginsburg , Brian R. LaneBrian R. Lane , Tudor BorzaTudor Borza , and for the Michigan Urological Surgery Improvement Collaborative View All Author Informationhttps://doi.org/10.1097/01.JU.0001009520.30626.80.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Preventable readmissions after radical prostatectomy (RP) are an important target for quality improvement (QI). Nonetheless, specific timing and cause of readmission, which are not reflected in a gross figure such as readmission rate, have distinct implications for potential intervention. We sought to identify actionable QI targets by characterizing the timing and reason for post-RP readmission. METHODS: We identified patients who underwent RP in the Michigan Urological Surgery Improvement Collaborative (MUSIC) registry between 1/2014 and 6/2023. The timing and reason for admission were characterized for readmissions within 30 days of discharge. We compared patient and disease factors and readmission etiology between early (0-7 days) and delayed (8-30 days) readmission via the Wilcoxon rank sum test, Fisher's exact test, or Pearson's chi-squared test as appropriate. RESULTS: Amongst 19,736 RP patients, 784 (4.0%) were readmitted. Of these readmissions, 446 (57%) were early and 338 (43%) were delayed (Figure 1). Patient and disease characteristics were similar between readmission groups, except Charlson score, which was lower in early readmissions (p=0.020). Infection (29%), gastrointestinal (GI) cause (23%), and urine leak (16%) were the most common reasons for readmission. GI-related causes were significantly more common amongst early readmissions (35% vs 8.3%, p<0.001), while infection (23% vs 37%, p<0.001), and urine leak (13% vs 20%, p=0.004) were more common amongst delayed readmissions. CONCLUSIONS: Over half of post-RP readmissions occurred within the first week following discharge. These early readmissions were frequently driven by GI issues (e.g., ileus), which may be potentially preventable. Efforts targeting GI causes, such as improved patient education and opioid-sparing pain management, represent a high yield area to decrease readmissions. Download PPT Source of Funding: Blue Cross Blue Shield of Michigan © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e563 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Patrick Lewicki More articles by this author Sabir Meah More articles by this author Corinne Labardee More articles by this author Anna Johnson More articles by this author Ryan J. Nelson More articles by this author James O. Peabody More articles by this author Alice Semerjian More articles by this author Kevin B. Ginsburg More articles by this author Brian R. Lane More articles by this author Tudor Borza More articles by this author for the Michigan Urological Surgery Improvement Collaborative More articles by this author Expand All Advertisement PDF downloadLoading ...