Impact of inflammatory bowel disease on radical prostatectomy outcomes and costs of care.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 230-230
Author(s):  
Ilana Goldberg ◽  
Steven Lee Chang ◽  
Shilajit Kundu ◽  
Benjamin I. Chung ◽  
Eric A. Singer

230 Background: Recent studies suggest an association between prostate cancer and inflammatory bowel disease (IBD). Our objectives were to investigate clinical and financial impacts of IBD on radical prostatectomy (RP), and to determine the impact of surgical approach on our findings. Methods: The Premier Hospital Database was queried for patients who underwent RP from 2003 to 2017. Multivariable logistic regression models were used to determine the independent impact of IBD on complications and readmission rates. We determined 90-day readmissions and examined 90-day hospital costs adjusted to 2019 US dollars with multivariable quantile regression models. Results: Our study population included 262,189 men with prostate cancer, including 3,408 (1.3%) with IBD. There were higher odds for any complication for IBD patients compared to non-IBD controls for RP (15.64% vs. 10.66%). IBD patients had overall complication rates of 14.1% ( P < 0.05) for open surgery and 17.2% for MIS ( P < 0.01). Between 2013-2017, the IBD cohort had significantly more complications (OR: 2; 95% CI: 1.5 to 2.67; P < 0.0001), was more likely to have surgical costs in the top quartile (OR: 1.6; 95% CI: 1.23 to 2.1; P < 0.01), and had higher readmission rates (OR: 1.51; 95% CI: 1.1 to 2.06; P = 0.01). Conclusions: The IBD cohort who underwent MIS had the highest complication rates. Hospital readmissions and surgical costs were significantly higher for the IBD cohort who underwent RP between 2013-2017, when a minimally invasive approach was more prevalent than an open approach. These findings may be important when deciding which surgical approach to take when performing RP on men with IBD. [Table: see text]

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 470-470
Author(s):  
Ilana Goldberg ◽  
Steven Lee Chang ◽  
Shilajit Kundu ◽  
Eric A. Singer

470 Background: Recent studies suggest an association between genitourinary malignancies and inflammatory bowel disease (IBD). Our objective was to investigate clinical and financial impacts of IBD on common major urologic cancer surgeries: radical prostatectomy (RP), radical cystectomy (RC), radical nephrectomy (RN), and partial nephrectomy (PN). Methods: Using ICD9 codes, the Premier Hospital Database was queried for patients who underwent one of four surgeries: RP, RC, RN, or PN from 2003 to 2015. The cohort was segregated into IBD patients and non-IBD patients. Multivariable logistic regression models were used to determine the independent impact of IBD on complication rates (by Clavien-Dindo classification and organ system) and readmission rates. Hospital cost differences between the two cohorts, adjusted to 2016 US dollars, were examined with multivariable quantile regression models. Results: Our study population included 220,192 patients with urological malignancies, 5165 (0.4%) of whom had IBD. After controlling for clinicodemographic variables, there were significantly higher odds for any complication (Clavien ≥1) for IBD patients compared to non-IBD controls for RC (Odds ratio [OR]: 3.04, 95% confidence interval [CI]: 1.25-7.43), RN (OR: 1.57, 95% CI: 1.1-2.23), and PN (OR: 1.5, 95% CI: 1.02-2.22). Specifically, IBD patients had significantly more gastrointestinal, infectious, and soft tissue complications. Readmission rates were significantly higher for IBD patients who underwent RC (OR: 2.50, 95% CI: 1.17-5.35) and PN (OR: 1.81, 95% CI: 1.17-2.80). Hospital costs were significantly elevated for IBD patients, ranging from +$893 (95% CI: 108-1677) to +$6261 (95% CI: 1861-10660). Conclusions: There was a significantly higher overall complication rate for IBD patients undergoing RC, RN, or PN compared to the non-IBD cohort. Hospital readmission rates were significantly higher for the IBD cohort who underwent RC and PN. Hospital costs associated with surgery were also increased for IBD patients. These findings may be important when counseling IBD patients about surgical outcomes and during development of enhanced recovery pathways or bundled payment programs.


Author(s):  
Ilana P. Goldberg ◽  
Steven L. Chang ◽  
Shilajit D. Kundu ◽  
Benjamin I. Chung ◽  
Eric A. Singer

2017 ◽  
Vol 152 (5) ◽  
pp. S790
Author(s):  
Mohammad Arsalan Siddiqui ◽  
Kartik Jinjuvadia ◽  
Jason Schairer ◽  
Raxitkumar Jinjuvadia

2016 ◽  
Vol 184 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Adi J. Klil-Drori ◽  
Koray Tascilar ◽  
Hui Yin ◽  
Armen Aprikian ◽  
Alain Bitton ◽  
...  

2015 ◽  
Vol 221 (4) ◽  
pp. e59
Author(s):  
Deborah S. Keller ◽  
Sean J. Langenfeld ◽  
Daniel E. Lomelin ◽  
Dmitry Oleynikov ◽  
Eric M. Haas

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