Changes in patient characteristics and outcomes for radical cystectomy in England.
OBJECTIVE
To describe temporal changes in patient characteristics and outcomes for radical cystectomy (RC) in England between 1995 and 2002, using routinely collected administrative data.


METHODS
Data were extracted from the Hospital Episode Statistics database of the Department of Health in England, describing all patients recorded as having undergone RC between 1995/1996 and 2001/2002; 8228 patients were included.


RESULTS
Of the patients who had undergone RC, two-thirds were > or = 65 years old and 75.6% were men. From 1995/1996 to 2001/2002 the annual number of RCs increased from 1013 to 1254, the proportion of patients admitted as an emergency decreased from 6.5% to 4.9%, the mean length of hospital stay decreased from 20.7 days to 18.7 days, and in-hospital mortality rates fell from 5.3% to 3.6%. The length of hospital stay and in-hospital mortality rates were higher in older patients, in female patients, and in those admitted as an emergency.


CONCLUSIONS
There was no sign of centralization of RCs over the study period, as the 25% increase in annual hospital volume was accompanied by a similar increase in the annual number of RCs. Length of hospital stay and in-hospital mortality rates have decreased.
Nuttall
Martin C
MC
Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK. mnuttall@reseng.ac.uk
van der Meulen
Jan
J
McIntosh
Gregor
G
Gillatt
David
D
Emberton
Mark
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy / Q000379:methods / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology / Q000601:surgery*; D014850:Waiting Lists