title: Complication and Readmission Rates following Same-Day Discharge after Percutaneous Renal Tumor Ablation.
abstract: OBJECTIVE
  To evaluate readmission rate and complications in patients undergoing same-day discharge following percutaneous thermal ablation of renal tumors.
  
  
  METHODS
  Patients undergoing same-day discharge following thermal ablation of renal tumors were reviewed. The primary outcome was the rate of readmission within 30 days of same-day discharge. The secondary outcomes included the rate and clinical outcomes of periprocedural complications.
  
  
  RESULTS
  Same-day discharge occurred in 166/174 patients (95%), of whom 2/166 (1%) required short-term readmission due to pulmonary embolism and acute-on-chronic kidney injury. Both patients recovered without permanent morbidity. Admission due to complications occurred in 8/174 (5%) cases, the majority of which were related to hemorrhage. No significant differences in rates of complications or admission were found between cryoablation and RF ablation. Major complications (Clavien-Dindo grade II or higher, SIR grade C or higher) occurred in 7/174 (4%) cases, the majority related to hemorrhage. All cases were detected in the standard 4 hour postprocedural observation period and managed conservatively. The mean hemorrhage volume was significantly larger in patients requiring admission versus those discharged the same day (289 mL vs 34 mL; P = .02). Higher-volume hemorrhage occurred in larger tumors (mean, 4.0 cm vs 3.0 cm; P = .04). There was no association between major complications and central tumor or age.
  
  
  CONCLUSIONS
  Routine same-day discharge following percutaneous renal tumor thermal ablation can be performed with a low rate of short-term readmission. The majority of periprocedural complications can be managed conservatively, and patients can be discharged the same day.
authors.affiliation: Division of Interventional Radiology, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.
authors.forename: James X
authors.initials: JX
authors.lastname: Chen
authors.affiliation: Department of Surgery, Division of Urology, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Guzzo
authors.affiliation: Department of Surgery, Division of Urology, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.
authors.forename: S Bruce
authors.initials: SB
authors.lastname: Malkowicz
authors.affiliation: Division of Interventional Radiology, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Soulen
authors.affiliation: Department of Surgery, Division of Urology, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Wein
authors.affiliation: Division of Interventional Radiology, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.
authors.forename: Timothy W I
authors.initials: TW
authors.lastname: Clark
authors.affiliation: Division of Interventional Radiology, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Nadolski
authors.affiliation: Division of Interventional Radiology, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104. Electronic address: stav@uphs.upenn.edu.
authors.forename: S William
authors.initials: SW
authors.lastname: Stavropoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003452:Cryosurgery; D005260:Female; D006801:Humans; D007668:Kidney / Q000601:surgery; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index