title: Incidence and Predictors of 30-Day Readmission in Patients Treated With Radical Cystectomy: A Single Center European Experience.
abstract: Previous studies showed high hospital readmission rates after radical cystectomy (RC) for bladder cancer (BCa), however at the time results of a European series analyzing this event were still missing.
  
  
  
  Overall, 1090 consecutive BCa patients treated with RC at a single center between January 2002 and August 2012 were identified. Logistic regression analyses were used to test the association between covariates and 30-day readmission in the overall population and after stratifying according age at the time of surgery.
  
  
  
  Mean length of stay (LOS) was 19 days (median, 16 days), and the overall 30-day readmission rate was 12.2%. The most frequent reasons for readmission at 30 days were ileus (n = 15; 11.3%), lymphoceles (n = 11; 8.3%), wound infection (n = 10; 7.5%), and fever (n = 12; 9.0%). In multivariable logistic regression analysis, age (odds ratio [OR], 1.02; P = .04) and LOS (OR, 0.94; P < .01) were associated with 30-day readmission. However, when analyzed according age at the time of surgery, a beneficial effect from a longer LOS was observed only in patients older than 70 years (P < .003).
  
  
  
  In the first European series on the effect of 30-day readmission, our data showed that even with a relative high mean LOS, 30-day readmission remained an ineradicable factor. Of note, older patients and shorter LOS were associated with an increased risk of readmission at 30 days, however, an increase of LOS to prevent readmission seemed effective only in patients older than 70 years.
authors.affiliation: Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, URI, Milan, Italy; Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy. Electronic address: marco.moschini87@gmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Moschini
authors.affiliation: Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, URI, Milan, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gandaglia
authors.affiliation: Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, URI, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Dell'Oglio
authors.affiliation: Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, URI, Milan, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Fossati
authors.affiliation: Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, URI, Milan, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Cucchiara
authors.affiliation: Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, URI, Milan, Italy.
authors.forename: Giusy
authors.initials: G
authors.lastname: Burgio
authors.affiliation: Klinik für Urologie, Luzerner Kantosspital, Lucerne, Switzerland.
authors.forename: Agostino
authors.initials: A
authors.lastname: Mattei
authors.affiliation: Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: Damiano
authors.affiliation: Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
authors.affiliation: Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, URI, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Salonia
authors.affiliation: Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, URI, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.affiliation: Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, URI, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Briganti
authors.affiliation: Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, URI, Milan, Italy.
authors.forename: Renzo
authors.initials: R
authors.lastname: Colombo
authors.affiliation: Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, URI, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Gallina
mesh_terms: D000368:Aged; D015653:Cystectomy / Q000009:adverse effects*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D001749:Urinary Bladder Neoplasms / Q000601:surgery*
keywords: Bladder cancer; Complications; European; Perioperative outcomes; Radical cystectomy; Readmission