Impact of annual surgical volume on length of stay in patients undergoing minimally invasive prostatectomy: A population-based study

L. Budäus, M. Morgan, F. Abdollah, K. C. Zorn, M. Sun, R. Johal, R. Thuret, A. Abdo, J. Schmitges, H. Isbarn, C. Jeldres, P. Perrotte, M. Graefen, P. I. Karakiewicz

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background: On average, patients remain hospitalized no more than 2 days after MIRP. The aim of our study was to examine the temporal trends in length of stay ≥3 days and to test the relationship between annual surgical volume (ASV) and annual hospital volume (AHV) and length of stay ≥3 days in patients undergoing MIRP. Material and methods: Within the Florida Hospital Inpatient Datafile, 2439 men who were treated with MIRP for prostate cancer between 2005 and 2008 were identified. Temporal trends were assessed and uni and multi-variable logistic regression models tested the relationship between ASV, AHV and length of stay ≥3 days. Results: The average length of stay decreased from 2.4 in 2005 to 1.7 days in 2008. Length of stay ≥3 days was recorded in 13.6% of patients and the proportion of patients staying more than ≥3 days decreased over time (25.5-12.2%; Chi Square trend p < 0.001). After stratification into low (<1-15 MIRPs) vs. intermediate (16-63 MIRPs) vs. high ASV tertiles (≥64 MIRPs) the proportion of patients with length of stay ≥3 days were 29.1; 13.2 and 11.1%. In multivariable logistic regression models predicting length of stay ≥3 days, ASV, year of surgery and comorbidities achieved independent predictor status and MIRP patients operated by highest ASV tertile surgeons were 71% (p < 0.001) less likely to be hospitalized for more than 3 days. Conclusion: The length of stay after MIRP decreased between 2005 and 2008. Surgical expertise represented one of the main determinants of shorter length of stay.

Original languageEnglish (US)
Pages (from-to)429-434
Number of pages6
JournalEuropean Journal of Surgical Oncology
Volume37
Issue number5
DOIs
StatePublished - May 2011

Keywords

  • Length of stay
  • Minimally invasive prostatectomy
  • Outcome-volume relationship
  • Surgical volume

ASJC Scopus subject areas

  • Surgery
  • Oncology

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