Predicting Factors of Unexpected Hospital Return Following Transurethral Resection of Bladder Tumor

Detalhes bibliográficos
Autor(a) principal: Marques, Vera
Data de Publicação: 2019
Outros Autores: Eliseu, Miguel, Tavares-da-Silva, Edgar, Rolo, Francisco, Figueiredo, Arnaldo
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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spelling 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
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