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First Canadian experience with same-day discharge after robot-assisted radical prostatectomy.
- Source :
-
Canadian Urological Association Journal . Feb2023, Vol. 17 Issue 2, p39-43. 5p. - Publication Year :
- 2023
-
Abstract
- INTRODUCTION: We aimed to evaluate the feasibility and safety of implementing a sameday discharge (SDD) protocol for robot-assisted radical prostatectomy (RARP) and pelvic lymph node dissection. METHODS: We performed a prospective cohort study including all consecutive eligible patients undergoing RARP in 2021 following initiation of SDD RARP protocol in April. Baseline characteristics were compared using t-tests, Mann-Whitney U tests, and odds ratios (OR) calculated using multiple logistic regression to assess for predictors of SDD success. RESULTS: A total of 117 patients underwent RARP in 2021 following initiation of the SDD protocol. Fifty-seven patients were initiated on the SDD pathway and 60 patients underwent surgery as an inpatient (IP-RARP). Of those on the SDD pathway (SDD-RARP), 33 (58%) were successfully discharged the same day of surgery, while 24 (42%) failed SDD. Baseline demographics were well-balanced between cohorts. Case order, increased patient age, and distance travelled to the hospital were factors associated with selection of patients for the IP-RARP protocol. In total, 12 SDD and 12 IP patients presented to the emergency department (p=1.0), and none within 24 hours of discharge. There were no hospital admissions in the SDD cohort, with four readmissions in the IP cohort (p=0.1). Multiple logistic regression revealed that case order (first case) was the only predictive factor for SDD success (OR 4.08, 95% confidence interval 1.59-11.62, p=0.005). CONCLUSIONS: Implementation of an SDD pathway following RARP is feasible, with no increase in rates of complications, unscheduled visits, or readmissions. [ABSTRACT FROM AUTHOR]
- Subjects :
- *SURGERY & psychology
*PELVIC surgery
*LYMPHADENECTOMY
*CONFIDENCE intervals
*HOSPITAL emergency services
*SURGICAL robots
*RADICAL prostatectomy
*MULTIPLE regression analysis
*PATIENTS
*MANN Whitney U Test
*PATIENT readmissions
*PATIENTS' attitudes
*HOSPITAL admission & discharge
*HUMAN services programs
*T-test (Statistics)
*DESCRIPTIVE statistics
*ODDS ratio
*PATIENT safety
*LONGITUDINAL method
Subjects
Details
- Language :
- English
- ISSN :
- 19116470
- Volume :
- 17
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Canadian Urological Association Journal
- Publication Type :
- Academic Journal
- Accession number :
- 161596112
- Full Text :
- https://doi.org/10.5489/cuaj.7914