There has been a shift from inpatient to outpatient surgery for commonly performed urological procedures, which has coincided with increasing rates of failure to rescue (FTR) mortality, according to a study published online in BJU International.

Jesse D. Sammon, DO, from Henry Ford Health System in Detroit, and colleagues analyzed data from the Nationwide Inpatient Sample to identify the discharges of all patients undergoing urological surgery from 1998 to 2010. The investigators assessed both overall and FTR mortality (death after a complication that was potentially recognizable and preventable).

An estimated 7,725,736 urological surgeries requiring hospitalization were performed over the study period. Results showed a significant 0.63% annual decline in admissions for urologic surgery and a slight decrease in the odds of overall mortality; however, the odds of mortality attributable to FTR increased 5% every year. Significant independent predictors of FTR mortality included age, race, Charlson Comorbidity Index, public insurance status, as well as urban hospital location.

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“These strata of high-risk individuals represent ideal targets for process improvement initiatives,” the authors wrote.