NEW ORLEANS, LA USA (UroToday.com) - Radical cystectomy (RC) is associated with a high rate of perioperative complication and readmission. These events increase costs while reimbursement for complications or readmissions decreases. Therefore, factors associated with or predicting readmission might be useful to identify patients at risk to attempt pre-emptive interventions.
Andrew McIntosh evaluated white blood cell count trend (WBCt) and final white blood cell count (fWBC) to determine if it might be associated with readmission. 477 RC patients from a single institution were identified from 2006-2013, 34% of whom were readmitted. WBCt (increasing or stable versus decreasing) did not associate with readmission. Using a threshold analysis, fWBC of 9000 cells/μL was shown to segregate readmitted patients optimally. 42% of patients with fWBC of > 9000 cells/μL were readmitted, but only 28% of patients with fWBC ≤ 9,000 cells/μL were readmitted, and this relationship was statistically significant. In multivariate analysis, fWBC > 9,000 cells/μL was associated with HR of 2.1 (95% CI 1.2-3.5) for readmission which was statistically significant, along with diversion type, in-house complication, discharge to rehabilitation facility, and length of stay > 10 days.
In the future, a nomogram for risk of readmission might be constructed to alter follow-up planning for RC patients.
Presented and reported by Philip Abbosh, MD, PhD at the American Urological Association (AUA) Annual Meeting - May 15 - 19, 2015 - New Orleans, LA USA
Fox Chase Cancer Center, Philadelphia, PA USA
Reported by Phillip H Abbosh, MD, PhD, medical writer for UroToday.com