ORLANDO—Radical nephrectomy is associated with higher readmission rates than partial nephrectomy among patients with kidney cancer, with open procedures, preoperative dialysis, and higher ASA score significant predictors of readmission, according to a study presented at the American Urological Association 2014 annual meeting. Partial nephrectomy (PN) is associated with low readmission rates.
Abram McBride, MD, and colleagues at the Department of Urology at the University of North Carolina School of Medicine in Chapel Hill examined the American College of Surgeons-National Surgical Quality Improvement Program database and identified kidney cancer patients who had underwent nephrectomy in 2011.
“Surgical readmissions account for 22% of total readmissions, but little data exist regarding urologic readmission rates for kidney cancer,” the authors noted in their study abstract.
In 438 patients treated with RN, about 47% underwent the open approach. The 30-day readmission rate was 8% for open RN in these patients compared with 3.9% among those undergoing laparoscopic RN. On multivariable analysis, surgical approach, preoperative dialysis, and higher ASA scores were associated with subsequent readmission.
Among 343 patients treated with PN, there was about an equal number of patients who underwent the open or laparoscopic approach, with similar 30-day readmission rates in both groups (4.7% and 4.6%, respectively). No significant covariates predicted readmission rates within 30 days on multivariable analysis.