Causes of hospital readmissions after XXXX surgery.

@entity1 @entity1625 @entity295 @entity548 @entity5 @entity281 @entity1410 @entity1031 @entity1211
OBJECTIVES: The Hospital Readmissions Reduction Program mandates reimbursement reductions to hospitals with higher than expected rates of readmissions. We examine causes and predictors of readmissions following major procedures in urologic oncology. MATERIALS AND METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program database, @entity1 undergoing radical prostatectomy (RP), radical (RN) or @entity1625 ( @entity1625 ), and radical cystectomy (RC) during the year 2012 were abstracted. Rates of unplanned readmission within 30 days after surgery, as well as causes of readmission, were identified. Multivariable logistic regression models were fitted to examine the association between @entity1 perioperative factors and odds of readmission. RESULTS: Overall, we observed a 5.5% unplanned 30-day readmission rate. Readmission rates for @entity1 treated with RP, RN, @entity1625 , and RC were 4.1%, 5.2%, 4.5%, and 15.9%, respectively. For each procedure, approximately two-third of readmissions occurred within the first 10 days following hospital discharge. Commonest causes of readmission after RP included @entity1031 (13.6%), wound (12.2%), renal/genitourinary (12.2%), and gastrointestinal (11.8%); after RN, wound (12.9%) and gastrointestinal (12.9%); after @entity1625 , renal/genitourinary (19.6%), cardiovascular (9.8%), and @entity548 / @entity1410 (9.8%); and after RC, renal/genitourinary (15.5%), wound (14.8%), and @entity295 / @entity281 (14.1%). RC was significantly associated with readmission. @entity1 undergoing open RP or @entity1625 were more likely to be readmitted relative to their minimally invasive counterparts (odds ratio = 1.53, 95% CI: 1.12-2.08, P = 0.007 and odds ratio = 2.51, 95% CI: 1.38-4.55, P = 0.003, respectively). CONCLUSIONS: Readmissions are relatively common following major urologic oncology procedures. Compared with RP, RN, or @entity1625 , RC @entity1 experience the highest burden of readmission. @entity1211 is a common modifiable cause of readmission following @entity5 surgery. Minimally invasive approach is associated with decreased odds of readmission following RP and @entity1625 .
