Objective
To assess readmission outcomes of a traditional ER pathway as well as a targeted postdischarge
intervention aimed at reducing hospital readmissions following RC.
Methods
A prospectively maintained clinical database was used to identify patients undergoing
RC before and after implementation of an ER protocol at our institution. An additional
intervention aimed at reducing hospital readmission included close postdischarge follow-up
and outpatient intravenous hydration (ER+). Inpatient length of stay (LOS) and readmission
rates were compared between groups using Wilcoxon Rank Sum and chi-square, respectively.
Univariate and multivariate logistic regression was used to identify factors associated
with hospital readmission.
Results
A total of 320 patients underwent RC, including 111 and 209 patients before and after
ER implementation. Median (IQR) LOS decreased from 8.0 (6.0-11.0) days to 5.0 (4.0-7.0)
days following ER implementation (P <.0001). Readmissions, however, were unchanged following ER implementation (P = .49). An additional targeted readmission reduction intervention (ER+) was associated
with significantly reduced hospital readmissions compared to traditional ER alone
(ER+ 5.9%, traditional ER 20.3%, P = .017).
Conclusion
ER protocols consistently demonstrate reductions in LOS, and should be the standard
of care following RC. In order to reduce readmissions, the urologic community must
expand beyond traditional ER pathways. We report significant reductions in hospital
readmission among RC patients receiving a targeted postdischarge intervention beyond
traditional ER alone.
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Article info
Publication history
Published online: April 06, 2020
Footnotes
Funding: None.
Disclosures: None.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
