Predicting Factors of Unexpected Hospital Return Following Transurethral Resection of Bladder Tumor
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.24915/aup.35.3-4.89 |
Resumo: | Introduction: We intend to evaluate which factors are associated with unexpected hospital return (UHR) following transurethral resection of bladder tumor (TURBT). Material and Methods: Exploratory cross-sectional study of all TURBTs performed between 2015-2016. Results: A total of 499 TURBTs were performed in 389 patients. Within 30 days of surgery, there was an UHR in 16.8% of cases, 4.2% demanding hospital readmission. UHR occurred mainly because of urinary tract infection (UTI) (38.1%). There was a significantly increased UHR in cases of primary tumour, larger tumor size, incomplete tumour resection, need for additional endoscopic procedures, higher surgery time, longer urethral catheterization, higher values of preoperative C-reactive protein (CRP) and lower preoperative hemoglobin. In a multivariate logistic regression analysis, we found a strong and independent association between UHR and length of surgery (OR = 1.016), duration of urethral catheterization (OR = 1.059) and preoperative CRP (OR = 1.131). Conclusion: Early UHR after programmed TURBT occurred in almost 17% of cases, mainly because of UTI. For each additional minute of surgery, each additional day of UC and each additional unit (mg/dL) of preoperative CRP, there is an increased risk of UHR in 1.6%, 5.9% and 13.1% respectively. As CRP value is not a modifiable variable, it is up to the surgeon to optimize the operative time and mainly the length of UC in order to reduce the probability of UHR. |
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Predicting Factors of Unexpected Hospital Return Following Transurethral Resection of Bladder TumorFatores Preditivos de Retorno Hospitalar Inesperado Após Ressecção Transuretral de Tumor VesicalCystoscopyPatient ReadmissionPostoperative ComplicationsRisk FactorsUrinary Bladder Neoplasms/surgeryCitoscopiaComplicações Pós-OperatóriasFactores de RiscoNeoplasias da Bexiga Urinária/cirurgiaReadmissão do DoenteIntroduction: We intend to evaluate which factors are associated with unexpected hospital return (UHR) following transurethral resection of bladder tumor (TURBT). Material and Methods: Exploratory cross-sectional study of all TURBTs performed between 2015-2016. Results: A total of 499 TURBTs were performed in 389 patients. Within 30 days of surgery, there was an UHR in 16.8% of cases, 4.2% demanding hospital readmission. UHR occurred mainly because of urinary tract infection (UTI) (38.1%). There was a significantly increased UHR in cases of primary tumour, larger tumor size, incomplete tumour resection, need for additional endoscopic procedures, higher surgery time, longer urethral catheterization, higher values of preoperative C-reactive protein (CRP) and lower preoperative hemoglobin. In a multivariate logistic regression analysis, we found a strong and independent association between UHR and length of surgery (OR = 1.016), duration of urethral catheterization (OR = 1.059) and preoperative CRP (OR = 1.131). Conclusion: Early UHR after programmed TURBT occurred in almost 17% of cases, mainly because of UTI. For each additional minute of surgery, each additional day of UC and each additional unit (mg/dL) of preoperative CRP, there is an increased risk of UHR in 1.6%, 5.9% and 13.1% respectively. As CRP value is not a modifiable variable, it is up to the surgeon to optimize the operative time and mainly the length of UC in order to reduce the probability of UHR.Introdução: Pretende-se avaliar que fatores estão associados a um retorno hospitalar inesperado (RHI) após a realização de ressecção transuretral de tumor vesical (RTU-TV). Material e Métodos: Realizado estudo exploratório transversal de todas as RTU-TV realizadas entre 2015-2016. Resultados: Realizaram-se 499 RTU-TV em 389 doentes. Nos primeiros 30 dias após a cirurgia, ocorreu RHI em 16,8% dos casos, com necessidade de reinternamento em 4,2%. A principal causa de RHI foi infeção do trato urinário (ITU) (38,1%). Verificou-se um RHI significativamente superior nos casos de tumor primário, de dimensões tumorais superiores, de RTU-TV incompleta, de necessidade de realização de procedimentos endoscópicos adicionais, de maior duração da cirurgia e da cateterização uretral (CU) e de valores pré-operatórios mais altos de proteína C reativa (PCR) e mais baixos de hemoglobina. Na análise multivariada, verificou-se uma associação forte e independente entre a ocorrência de RHI e duração da cirurgia (OR = 1,016), duração da CU (OR = 1,059), e valores médios de PCR pré-operatória (OR = 1,131). Conclusão: Um RHI precoce após RTU-TV ocorreu em quase 17% dos casos, sobretudo devido a ITU. Por cada minuto de cirurgia adicional, por cada dia adicional de CU e por cada unidade adicional de PCR pré-operatória, existe um aumento do risco de RHI de 1,6%, 5,9% e 13,1%, respetivamente. Sendo a PCR uma variável não modificável, cabe ao cirurgião otimizar o tempo operatório e, sobretudo, a duração da CU de modo a reduzir a probabilidade de RHI.Associação Portuguesa de Urologia2019-01-19T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.24915/aup.35.3-4.89oai:oai.actaurologicaportuguesa.com:article/89Acta Urológica Portuguesa; Vol. 35 No. 3-4 (2018): July-September; October-December; 18-24Acta Urológica Portuguesa; v. 35 n. 3-4 (2018): Julho-Setembro; Outubro-Dezembro; 18-242387-04192341-4022reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttp://www.actaurologicaportuguesa.com/index.php/aup/article/view/89https://doi.org/10.24915/aup.35.3-4.89http://www.actaurologicaportuguesa.com/index.php/aup/article/view/89/43Copyright (c) 2018 Portuguese Association of Urologyinfo:eu-repo/semantics/openAccessMarques, VeraEliseu, MiguelTavares-da-Silva, EdgarRolo, FranciscoFigueiredo, Arnaldo2022-09-21T09:04:47Zoai:oai.actaurologicaportuguesa.com:article/89Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:55:54.250713Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Predicting Factors of Unexpected Hospital Return Following Transurethral Resection of Bladder Tumor Fatores Preditivos de Retorno Hospitalar Inesperado Após Ressecção Transuretral de Tumor Vesical |
title |
Predicting Factors of Unexpected Hospital Return Following Transurethral Resection of Bladder Tumor |
spellingShingle |
Predicting Factors of Unexpected Hospital Return Following Transurethral Resection of Bladder Tumor Marques, Vera Cystoscopy Patient Readmission Postoperative Complications Risk Factors Urinary Bladder Neoplasms/surgery Citoscopia Complicações Pós-Operatórias Factores de Risco Neoplasias da Bexiga Urinária/cirurgia Readmissão do Doente |
title_short |
Predicting Factors of Unexpected Hospital Return Following Transurethral Resection of Bladder Tumor |
title_full |
Predicting Factors of Unexpected Hospital Return Following Transurethral Resection of Bladder Tumor |
title_fullStr |
Predicting Factors of Unexpected Hospital Return Following Transurethral Resection of Bladder Tumor |
title_full_unstemmed |
Predicting Factors of Unexpected Hospital Return Following Transurethral Resection of Bladder Tumor |
title_sort |
Predicting Factors of Unexpected Hospital Return Following Transurethral Resection of Bladder Tumor |
author |
Marques, Vera |
author_facet |
Marques, Vera Eliseu, Miguel Tavares-da-Silva, Edgar Rolo, Francisco Figueiredo, Arnaldo |
author_role |
author |
author2 |
Eliseu, Miguel Tavares-da-Silva, Edgar Rolo, Francisco Figueiredo, Arnaldo |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Marques, Vera Eliseu, Miguel Tavares-da-Silva, Edgar Rolo, Francisco Figueiredo, Arnaldo |
dc.subject.por.fl_str_mv |
Cystoscopy Patient Readmission Postoperative Complications Risk Factors Urinary Bladder Neoplasms/surgery Citoscopia Complicações Pós-Operatórias Factores de Risco Neoplasias da Bexiga Urinária/cirurgia Readmissão do Doente |
topic |
Cystoscopy Patient Readmission Postoperative Complications Risk Factors Urinary Bladder Neoplasms/surgery Citoscopia Complicações Pós-Operatórias Factores de Risco Neoplasias da Bexiga Urinária/cirurgia Readmissão do Doente |
description |
Introduction: We intend to evaluate which factors are associated with unexpected hospital return (UHR) following transurethral resection of bladder tumor (TURBT). Material and Methods: Exploratory cross-sectional study of all TURBTs performed between 2015-2016. Results: A total of 499 TURBTs were performed in 389 patients. Within 30 days of surgery, there was an UHR in 16.8% of cases, 4.2% demanding hospital readmission. UHR occurred mainly because of urinary tract infection (UTI) (38.1%). There was a significantly increased UHR in cases of primary tumour, larger tumor size, incomplete tumour resection, need for additional endoscopic procedures, higher surgery time, longer urethral catheterization, higher values of preoperative C-reactive protein (CRP) and lower preoperative hemoglobin. In a multivariate logistic regression analysis, we found a strong and independent association between UHR and length of surgery (OR = 1.016), duration of urethral catheterization (OR = 1.059) and preoperative CRP (OR = 1.131). Conclusion: Early UHR after programmed TURBT occurred in almost 17% of cases, mainly because of UTI. For each additional minute of surgery, each additional day of UC and each additional unit (mg/dL) of preoperative CRP, there is an increased risk of UHR in 1.6%, 5.9% and 13.1% respectively. As CRP value is not a modifiable variable, it is up to the surgeon to optimize the operative time and mainly the length of UC in order to reduce the probability of UHR. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-01-19T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.24915/aup.35.3-4.89 oai:oai.actaurologicaportuguesa.com:article/89 |
url |
https://doi.org/10.24915/aup.35.3-4.89 |
identifier_str_mv |
oai:oai.actaurologicaportuguesa.com:article/89 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
http://www.actaurologicaportuguesa.com/index.php/aup/article/view/89 https://doi.org/10.24915/aup.35.3-4.89 http://www.actaurologicaportuguesa.com/index.php/aup/article/view/89/43 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2018 Portuguese Association of Urology info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2018 Portuguese Association of Urology |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Associação Portuguesa de Urologia |
publisher.none.fl_str_mv |
Associação Portuguesa de Urologia |
dc.source.none.fl_str_mv |
Acta Urológica Portuguesa; Vol. 35 No. 3-4 (2018): July-September; October-December; 18-24 Acta Urológica Portuguesa; v. 35 n. 3-4 (2018): Julho-Setembro; Outubro-Dezembro; 18-24 2387-0419 2341-4022 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
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1799130427718369280 |