We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Conversion to Open Radical or Partial Nephrectomy Associated with Unplanned Hospital Readmission After Attempted Minimally Invasive Approach.
- Authors
Razdan, Shirin; Okhawere, Kennedy; Wilson, Michael; Nkemdirim, William; Korn, Talia; Meilika, Kirolos; Badani, Ketan
- Abstract
Introduction/Objectives: We endeavored to explore the rates of unplanned hospital readmission (UHR) in patients who underwent minimally invasive radical or partial nephrectomy who were subsequently converted to open surgery. Patients and Methods: The National Cancer Database (NCDB) was used for this study. Patients diagnosed with renal cancer and who had minimally invasive partial or radical nephrectomy from 2004 to 2016 were included in the study. Patients were categorized as converted or not converted to open surgery. UHR was the outcome of the study and was defined as UHR within 30 days of discharge. We conducted a one-to-one nearest-neighbor propensity-score matching using baseline clinical, tumor, and facility characteristics. To evaluate the relationship between conversion to open surgery and UHR, we conducted a multivariable logistic regression on the propensity-matched cohort, a propensity score-matched model without controlling for any covariate, and a propensity score-adjusted model, controlling for only the propensity score. Results: A total of 142,040 patients were identified, with a 2.98% conversion rate. There was an overall decrease in the rate of conversion to open surgery from 2010 (4.11%) to 2016 (2.43%). Laparoscopic radical nephrectomy remained a significant contributor to the rate of conversion (at least 50% per year). In the unmatched cohort, the UHR rate was higher among those who had a conversion to open surgery (n = 710, 0.52% versus n = 44, 1.04%; P < .001). Similarly, in the propensity score-matched cohort, the UHR rate was higher among those who had a conversion to open (n = 22, 0.52% versus n = 44, 1.04%; P = .007). After controlling for other factors, conversion to open remained independently associated with UHF. Conclusion: Conversion to open radical or partial nephrectomy from a minimally invasive approach is independently associated with an increased risk of 30-day UHR.
- Subjects
NEPHRECTOMY; PATIENT readmissions; RENAL cancer; RENAL cell carcinoma; RATINGS of hospitals; LOGISTIC regression analysis; CANCER diagnosis; SURGICAL robots; MINIMALLY invasive procedures; OPERATIVE surgery; RETROSPECTIVE studies; KIDNEY tumors; LAPAROSCOPY
- Publication
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2022, Vol 32, Issue 8, p823
- ISSN
1092-6429
- Publication type
journal article
- DOI
10.1089/lap.2021.0537