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

  • Vera Marques Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Miguel Eliseu Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Edgar Tavares-da-Silva Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Francisco Rolo Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Arnaldo Figueiredo Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
Keywords: Cystoscopy, Patient Readmission, Postoperative Complications, Risk Factors, Urinary Bladder Neoplasms/surgery

Abstract

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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Published
2019-01-19