AUA 2014: Predicting Post-Nephrectomy Readmissions


The Particulars: Previous research suggests that readmissions are common following major abdominal surgery for cancer. Other studies, however, indicate that surgical readmissions account for only about 22% of total readmissions. Little is known about urologic readmission rates for kidney cancer patients.

Data Breakdown: Investigators in North Carolina reviewed national data on patients who underwent nephrectomy for kidney cancer in 2011 in order to evaluate predictors of readmissions. Readmission rates were 8.0% for open radical nephrectomy and 3.9% for laparoscopic radical nephrectomy. Preoperative dialysis (odds ratio [OR], 9.8), using an open surgical approach (OR, 0.31), and high American Society of Anesthesiologists (ASA) scores (OR, 4.9) were significant predictors of readmission. Readmission rates were about 4.5% for patients who underwent open or laparoscopic partial nephrectomy.

Take Home Pearls: Regardless of the surgical approach that is used, readmission rates following partial nephrectomy appear to be low. However, readmission rates with radical nephrectomy appear to be higher, particularly when an open approach is used, among patients on dialysis before surgery, and in those with high ASA scores.

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