Document Detail


Impact of Complications and Hospital-Free Days following Radical Cystectomy on Health-Related Quality of Life at One Year.
MedLine Citation:
PMID:  24928268     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: We sought to determine the extent to which complications, as well as the number of "hospital-free days" (HFDs) within 30 and 90 days of surgery predicted HRQOL at one year following radical cystectomy (RC).
MATERIALS AND METHODS: We used data from a prospective HRQOL study using a validated instrument, the Vanderbilt Cystectomy Index-15 (VCI-15). Complications were graded by the Clavien system, and hospital length of stay and length of stay during readmissions were used to calculate 30- and 90-day HFDs, respectively. We compared the number of HFDs among patients with varying levels of complications. Multivariable analysis was performed to determine predictors of VCI-15 score one year after surgery adjusting for demographic (age, gender, comorbidities) and clinical variables (stage, and diversion type)).
RESULTS: A total of 100 patients with complete baseline and one year follow-up HRQOL data were included in the analysis. The median (IQR) 30 and 90-day HFDs were 24 (22-25) and 84 (82-85) days, respectively. Patients who experienced any complications had significantly fewer 30d HFDs (22 vs. 24 days, p<0.01) and 90d HFDs (81 vs. 84 days, p<0.01), and patients with higher grade complications had fewer HFDs than those with lower-grade or no complications (p<0.01). On multivariable analysis, female gender and baseline VCI-15 score independently predicted higher one year HRQOL scores.
CONCLUSIONS: Patients who experience complications following RC have fewer 30- and 90-day HFDs, however neither predicts HRQOL at one year. Instead, long-term HRQOL appears to be driven largely by baseline HRQOL and gender.
Authors:
Chad R Ritch; Michael S Cookson; Sam S Chang; Peter E Clark; Matthew J Resnick; David F Penson; Joseph A Smith; Alex T May; Christopher B Anderson; Chaochen You; Haerin Lee; Daniel A Barocas
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-10
Journal Detail:
Title:  The Journal of urology     Volume:  -     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
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