Mahmoud I Khalil1, Naleen Raj Bhandari2, Nalin Payakachat2, Rodney Davis3, Omer A Raheem4, Mohamed H Kamel5. 1. Department of Urology, University of Arkansas for Medical Sciences, Little Rock, AR; Department of Urology, Ain Shams University, Cairo, Egypt. 2. Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences, Little Rock, AR. 3. Department of Urology, University of Arkansas for Medical Sciences, Little Rock, AR. 4. Department of Urology, Tulane University, New Orleans, LA. 5. Department of Urology, University of Arkansas for Medical Sciences, Little Rock, AR; Department of Urology, Ain Shams University, Cairo, Egypt. Electronic address: mkamel@uams.edu.
Abstract
OBJECTIVES: To compare the early (≤30 days) postoperative mortality and morbidity in patients who underwent robot-assisted radical prostatectomy (RARP) and were discharged the same surgery day to a propensity score matched patient population of RARP who stayed >1 day in hospital. METHODS: The National Surgical Quality Improvement Program data of the American College of Surgeons was queried to identify patients who underwent RARP with same day hospital discharge (OPG) and those who stayed >1 day (IPG). Each OPG patient was matched to 5 IPG patients using a propensity score. Rates of early postoperative mortality, morbidity, reoperation and readmission were described for both groups. The risks of morbidity and mortality in the OPG patients compared to IPG patients were reported as a relative risk (RR, 95% CI), for adjusting for the matched study design. RESULTS: A total of 258 patients in OPG were matched to 1,290 IPG patients. Early postoperative mortality was recorded in only 2 (0.2%) IPG patients. Comparing OPG to IPG, the overall morbidity (3.1% vs. 4.7%, RR: 0.65, CI: 0.32-1.35), reoperation rates (2.3% vs. 0.8%, RR: 1.82, CI: 0.63, 5.28), and readmission rates (2.6% vs. 3.9%, RR: 0.5, CI: 0.30, 1.55) were low and not significantly different between the 2 groups. CONCLUSIONS: The overall rates of early postoperative morbidity, mortality, readmission, and reoperation were low among outpatient RARP patients. These outcomes were also not significantly different than a propensity score matched group of inpatient RARP patients.
OBJECTIVES: To compare the early (≤30 days) postoperative mortality and morbidity in patients who underwent robot-assisted radical prostatectomy (RARP) and were discharged the same surgery day to a propensity score matched patient population of RARP who stayed >1 day in hospital. METHODS: The National Surgical Quality Improvement Program data of the American College of Surgeons was queried to identify patients who underwent RARP with same day hospital discharge (OPG) and those who stayed >1 day (IPG). Each OPGpatient was matched to 5 IPGpatients using a propensity score. Rates of early postoperative mortality, morbidity, reoperation and readmission were described for both groups. The risks of morbidity and mortality in the OPGpatients compared to IPGpatients were reported as a relative risk (RR, 95% CI), for adjusting for the matched study design. RESULTS: A total of 258 patients in OPG were matched to 1,290 IPGpatients. Early postoperative mortality was recorded in only 2 (0.2%) IPGpatients. Comparing OPG to IPG, the overall morbidity (3.1% vs. 4.7%, RR: 0.65, CI: 0.32-1.35), reoperation rates (2.3% vs. 0.8%, RR: 1.82, CI: 0.63, 5.28), and readmission rates (2.6% vs. 3.9%, RR: 0.5, CI: 0.30, 1.55) were low and not significantly different between the 2 groups. CONCLUSIONS: The overall rates of early postoperative morbidity, mortality, readmission, and reoperation were low among outpatient RARP patients. These outcomes were also not significantly different than a propensity score matched group of inpatient RARP patients.