Incidence and predictors of early and late hospital readmission after transurethral resection of the prostate: a population-based cohort study

Abstract Background Tonsillectomy, with or without adenoidectomy, is the leading reason for paediatric unplanned hospital readmission, some of which are potentially avoidable. Reducing unplanned hospital revisits would improve patient safety and decrease use of healthcare resources. This study aimed to describe the incidence, timing and risk factors for any surgery-related hospital revisits (both emergency presentation and readmission) following paediatric tonsillectomy and adenotonsillectomy in a large state-wide cohort. Methods We conducted a population-based cohort study using linked administrative datasets capturing all paediatric tonsillectomy and adenotonsillectomy surgeries performed between 2010 and 2015 in the state of Victoria, Australia. The primary outcome was presentation to the emergency department or hospital readmission within 30-day post-surgery. Results Between 2010 and 2015, 46,583 patients underwent 47,054 surgeries. There was a total of 4758 emergency department presentations (10.11% total surgeries) and 2750 readmissions (5.84% total surgeries). Haemorrhage was the most common reason for both revisit types, associated with 33.02% of ED presentations (3.34% total surgeries) and 67.93% of readmissions (3.97% total surgeries). Day 5 post-surgery was the median revisit time for both ED presentations (IQR 3–7) and readmission (IQR 3–8). Predictors of revisit included older age, public and metropolitan hospitals and peri-operative complications during surgery. Conclusions Haemorrhage was the most common reason for both emergency department presentation and hospital readmission. The higher risk of revisits associated with older children, surgeries performed in public and metropolitan hospitals, and in patients experiencing peri-operative complications, suggest the need for improved education of postoperative care for caregivers, and avoidance of inappropriate early discharge. Graphical Abstract

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Re: Is Diabetes Mellitus Associated with Clinical Outcomes in Aging Males Treated with Transurethral Resection of Prostate for Bladder Outlet Obstruction: Implications from Taiwan Nationwide Population-Based Cohort Study

The Journal of Urology ◽

10.1016/j.juro.2017.11.101 ◽

2018 ◽

Vol 199 (3) ◽

pp. 587-588

Author(s):

Steven A. Kaplan

Keyword(s):

Diabetes Mellitus ◽

Cohort Study ◽

Clinical Outcomes ◽

Transurethral Resection ◽

Bladder Outlet Obstruction ◽

Outlet Obstruction ◽

Population Based ◽

Transurethral Resection Of Prostate

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Is diabetes mellitus associated with clinical outcomes in aging males treated with transurethral resection of prostate for bladder outlet obstruction: implications from Taiwan Nationwide Population-Based Cohort Study

Clinical Interventions in Aging ◽

10.2147/cia.s126207 ◽

2017 ◽

Vol Volume 12 ◽

pp. 535-541 ◽

Cited By ~ 6

Author(s):

Yu-Hsiang Lin ◽

Chen-Pang Hou ◽

Tien-Hsing Chen ◽

Horng-Heng Juang ◽

Phei-Lang Chang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Cohort Study ◽

Clinical Outcomes ◽

Transurethral Resection ◽

Bladder Outlet Obstruction ◽

Outlet Obstruction ◽

Population Based ◽

Transurethral Resection Of Prostate

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Hydroxycarbamide adherence and cumulative dose associated with hospital readmission in sickle cell disease: a 6-year population-based cohort study

British Journal of Haematology ◽

10.1111/bjh.15396 ◽

2018 ◽

Vol 182 (2) ◽

pp. 259-270 ◽

Cited By ~ 10

Author(s):

Jifang Zhou ◽

Jin Han ◽

Edith A. Nutescu ◽

Victor R. Gordeuk ◽

Santosh L. Saraf ◽

...

Keyword(s):

Cohort Study ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Cumulative Dose ◽

Hospital Readmission ◽

Population Based ◽

Cell Disease

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Preoperative treatment with 5α-reductase inhibitors and the risk of hemorrhagic events in patients undergoing transurethral resection of the prostate – A population-based cohort study

Clinics ◽

10.6061/clinics/2018/e264 ◽

2018 ◽

Vol 73 ◽

Cited By ~ 2

Author(s):

TY Yang ◽

M Chen ◽

WR Lin ◽

CY Li ◽

WK Tsai ◽

...

Keyword(s):

Cohort Study ◽

Transurethral Resection ◽

Population Based ◽

Preoperative Treatment ◽

Reductase Inhibitors ◽

Hemorrhagic Events

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Risk Factors and Outcomes of Early Hospital Readmission in Canadian Kidney Transplant Recipients: A Population-Based Multi-Center Cohort Study

Canadian Journal of Kidney Health and Disease ◽

10.1177/20543581211060926 ◽

2021 ◽

Vol 8 ◽

pp. 205435812110609

Author(s):

Kyla L. Naylor ◽

Gregory A. Knoll ◽

Justin Slater ◽

Eric McArthur ◽

Amit X. Garg ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Kidney Transplant ◽

Hospital Readmission ◽

Graft Failure ◽

Population Based ◽

Income Quintile ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Increased Risk

Background: Early hospital readmissions (EHRs) occur commonly in kidney transplant recipients. Conflicting evidence exists regarding risk factors and outcomes of EHRs. Objective: To determine risk factors and outcomes associated with EHRs (ie, hospitalization within 30 days of discharge from transplant hospitalization) in kidney transplant recipients. Design: Population-based cohort study using linked, administrative health care databases. Setting: Ontario, Canada. Patients: We included 5437 kidney transplant recipients from 2002 to 2015. Measurements: Risk factors and outcomes associated with EHRs. We assessed donor, recipient, and transplant risk factors. We also assessed the following outcomes: total graft failure, death-censored graft failure, death with a functioning graft, mortality, and late hospital readmission. Methods: We used multivariable logistic regression to examine the association of each risk factor and the odds of EHR. To examine the relationship between EHR status (yes vs no [reference]) and the outcomes associated with EHR (eg, total graft failure), we used a multivariable Cox proportional hazards model. Results: In all, 1128 kidney transplant recipients (20.7%) experienced an EHR. We found the following risk factors were associated with an increased risk of EHR: older recipient age, lower income quintile, several comorbidities, longer hospitalization for initial kidney transplant, and older donor age. After adjusting for clinical characteristics, compared to recipients without an EHR, recipients with an EHR had an increased risk of total graft failure (adjusted hazard ratio [aHR]: 1.46, 95% CI: 1.29, 1.65), death-censored graft failure (aHR: 1.62, 95% CI: 1.36, 1.94), death with graft function (aHR: 1.34, 95% CI: 1.13, 1.59), mortality (aHR: 1.41, 95% CI: 1.22, 1.63), and late hospital readmission in the first 0.5 years of follow-up (eg, 0 to <0.25 years: aHR: 2.11, 95% CI: 1.85, 2.40). Limitations: We were not able to identify which readmissions could have been preventable and there is a potential for residual confounding. Conclusions: Results can be used to identify kidney transplant recipients at risk of EHR and emphasize the need for interventions to reduce the risk of EHRs. Trial registration: This is not applicable as this is a population-based cohort study and not a clinical trial.

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