Faculty Collaboration Database

Impact of Post-Hospital Syndrome on Penile Prosthesis Outcomes: A Period of Global Health Risk. J Urol 2019 Jan;201(1):154-159

Date

08/21/2018

Pubmed ID

30125569

DOI

10.1016/j.juro.2018.08.039

Scopus ID

2-s2.0-85059246089 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

PURPOSE: Post-hospital syndrome is an acquired transient period of health vulnerability following inpatient admission. We assessed the impact of a preoperative hospitalization on outcomes following penile prosthesis surgery and sought to optimize surgical timing after inpatient admission.

MATERIALS AND METHODS: We used the Healthcare Cost and Utilization Project State Inpatient Databases and State Ambulatory Surgery Database for California from 2007 to 2011 and for Florida from 2009 to 2014. Patients were identified as having undergone prosthesis placement by ICD-9 and CPT codes. The primary exposure was post-hospital syndrome, defined as any inpatient admission 90 days or less before prosthesis placement. Patients were further categorized by how recently the inpatient hospitalization occurred. The primary study outcome was 30-day hospital readmission. Secondary outcomes were length of stay, and device and postoperative complications.

RESULTS: We identified 16,923 patients who received a penile prosthesis, of whom 477 (3%) had post-hospital syndrome exposure 90 days or less before prosthesis placement. After risk adjustment patients with post-hospital syndrome had higher odds of 30-day readmission (OR 3.0, 95% CI 2.2-4.1), length of stay 2 days or longer (OR 1.7, 95% CI 1.3-2.3) and device complications (OR 1.7, 95% CI 1.2-2.5). When categorizing patients by 30-day intervals, we found a linear decrease in the risk of 30-day readmission as the interval increased between post-hospital syndrome exposure and prosthesis surgery.

CONCLUSIONS: Post-hospital syndrome exposure is a risk adjusted predictor of 30-day readmissions, prolonged length of stay and device complications. Medical optimization and delayed surgery can help combat the adverse effects associated with post-hospital syndrome exposure and may improve surgical outcomes.

Author List

Kirshenbaum EJ, Nelson M, Hehemann MC, Kothari AN, Eguia E, Farooq A, Bresler L, Gupta G, Santos GD

Author

Anai N. Kothari MD Assistant Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
California
Florida
Global Health
Hospitalization
Humans
Male
Middle Aged
Penile Implantation
Penile Prosthesis
Postoperative Complications
Retrospective Studies
Risk Assessment
Socioeconomic Factors
Syndrome
Time Factors
Treatment Outcome