Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Dagnino, F; Labban, M; Berk, B; Qian, Z; Stelzl, D; Zurl, H; Korn, S; Lughezzani, G; Buffi, NM; Cole, AP; Kibel, AS; Trinh, QD; Niknejad, KG.
Trends and Safety of Same-Day Discharge for Robot-Assisted Laparoscopic Prostatectomy: a Comparison between the Pre-Pandemic and Pandemic Periods from the National Cancer Database.
Urology. 2024;
Doi: 10.1016/j.urology.2024.10.049
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Zurl Hanna
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- Abstract:
- OBJECTIVE: To assess and compare the use of same-day discharge (SDD) for robot-assisted laparoscopic prostatectomy (RALP) between the "Pre-pandemic" and "Pandemic" periods and investigate SDD impact on mortality and readmissions. MATERIALS AND METHODS: We examined data from the National Cancer Database on men receiving RALP in the "Pre-pandemic" (2018-2019) and "Pandemic" (2020) periods. We analyzed the differences in patient and hospital characteristics between SDD and non-SDD patients. Multivariable logistic regression analysis was performed to evaluate the likelihood of SDD during "Pandemic" versus "Pre-pandemic" periods. Inverse probability treatment weighting (IPTW) was utilized to assess the impact of SDD on 30-day mortality, 90-day mortality, and 30-day readmissions, adjusting for patient and hospital characteristics. RESULTS: Out of 111,117 men, 8,997 (8%) received SDD. Patients with more comorbidities, non-private insurance, and high-risk prostate cancer reported lower SDD rates (p<0.001). Higher SDD rates were observed at academic facilities and those in the top RALP volume quartile (p<0.001). Patients who underwent RALP during the "Pandemic" period had increased odds of SDD compared to those receiving RALP in the "Pre-pandemic" period (aOR 1.37; 95%CI 1.31-1.45; p<0.001). When comparing SDD and non-SDD patient outcomes, after IPTW adjustment, there was no difference in the odds of 30-day mortality (aOR 0.98; 95%CI 0.47-2.01; p=0.95), 90-day mortality (aOR 1.09; 95%CI 0.60-1.97; p=0.76), or 30-day readmissions (aOR 0.90; 95%CI 0.76-1.06, p=0.21). CONCLUSION: SDD for RALP increased steadily after pandemic. Identifying factors and necessary resources to standardize SDD for RALP will be crucial for its widespread adoption in the coming years.