title: Predictors of costs for robotic-assisted laparoscopic radical prostatectomy.
abstract: OBJECTIVE
  Information on the association of perioperative parameters with costs for robotic-assisted laparoscopic radical prostatectomy (RALP) is lacking. Understanding factors that impact cost may allow reduction in cost of prostate cancer care. We identified factors associated with higher costs in a contemporary series of RALP.
  
  
  METHODS
  Total direct cost and clinicopathologic data were available for 264 patients who underwent RALP at our institution between May 2005 and April 2008. We performed linear regression analyses to identify predictors of direct cost using preoperative, intraoperative, and postoperative variables.
  
  
  RESULTS
  On univariable analyses, operating room (OR) time, placement of a pelvic drain (both P<0.001), complications during surgery (P=0.002) or hospitalization, blood transfusion, and length of stay (all P<0.001) were associated with higher direct costs. On multivariable analysis, none of the preoperative features were found to predict direct costs. Of the intraoperative factors, OR time (P<0.001) and pelvic drain placement (P=0.006) were associated with higher direct costs. A longer OR time, length of stay, and usage of transfusions (all P<0.001) during the postoperative course were independently associated with higher direct costs.
  
  
  CONCLUSIONS
  Of factors that are available preoperatively, none seems to be useful to predict added costs for individual patients undergoing RALP. Higher costs for RALP are driven by events occurring during the procedure or postoperative hospital stay.
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390, USA.
authors.forename: Christian
authors.initials: C
authors.lastname: Bolenz
authors.forename: Amit
authors.initials: A
authors.lastname: Gupta
authors.forename: Claus G
authors.initials: CG
authors.lastname: Roehrborn
authors.forename: Yair
authors.initials: Y
authors.lastname: Lotan
mesh_terms: D000368:Aged; D003365:Costs and Cost Analysis; D006801:Humans; D010535:Laparoscopy / Q000191:economics*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011468:Prostatectomy / Q000191:economics* / Q000379:methods*; D011471:Prostatic Neoplasms / Q000191:economics* / Q000601:surgery*; D012189:Retrospective Studies; D012371:Robotics / Q000191:economics*