Early discharge and post‐discharge outcomes in patients undergoing radical cystectomy for bladder cancer

Abstract

Early discharge after RC was not associated with increased readmissions or post-discharge complications. Future prospective studies, with defined peri-operative care pathways, are needed to identify potential components that may enable hospitals to discharge patients early without compromising post-discharge outcomes.

Selecting candidates for early discharge after radical cystectomy for bladder cancer

“…Furthermore, subgroup analysis in the publication by Xia et al ( 3 ) revealed that the odds of readmission after early discharge were the same for all subsets of patients except for patients aged ≥85 years. Although the impact of age on outcome is of importance it needs to be emphasized that these data should be interpreted with caution, as only 89 patients included in the analysis were aged ≥85 years of whom 20 patients were discharged early.…”

“…Xia et al assessed whether discharging patients early after RC is associated with an increased risk of readmission and post-discharge complications ( 3 ). Based on a retrospective analysis of the National Surgical Quality Improvement Program database they concluded that early discharge can be performed safely in a subgroup of patients after RC.…”

“…The authors identified several risk factors relevant for selecting optimal candidates for early discharge after RC. Patients most suited for early discharge are patients with normal BMI, lower comorbidity score, non-continent diversion, shorter operation time and no/fewer pre-discharge complications ( 3 ). However, other important risk factors, such as functional status ( 4 , 5 ), cardiorespiratory fitness ( 6 ), nutritional deficiency ( 4 ) and mental health ( 7 ) also play an important role in the risk of morbidity following RC and were not assessed in this study ( 3 ).…”

“…No standardised ERAS protocol is available and consequently perioperative care differs significantly between countries and hospitals. In the publication by Xia et al , detailed information about the perioperative care programs applied in the participating hospitals is lacking ( 3 ).…”

“…LOS is also decreased in higher volume centres. The potential impact of volume of hospital or surgeon on LOS was not examined in the paper by Xia et al ( 3 ).…”