Readmission and reoperation after midurethral sling

Erik D. Hokenstad, Amy E. Glasgow, Elizabeth B Habermann, John A. Occhino

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction and hypothesis: We aimed to determine the rate of readmission and reoperation for patients undergoing midurethral sling (MUS) placement for stress urinary incontinence (SUI). Methods: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was queried to identify all isolated MUS placed from 2012 through 2015 using the Current Procedural Terminology 4 (CPT-4) code for MUS with or without cystoscopy (57,288 ± 52,000). The cohort was then reviewed for unplanned, related readmissions and reoperations within 30 days of MUS placement. Results: Isolated MUS was placed in 9910 patients. Fifty-eight (0.59%) patients were readmitted and 81 (0.82%) had reoperation. The most common indications for readmission were related to the urinary tract, i.e., urinary retention (27.6%), non-surgical-site-related infection (15.5%), and medical related issues (15.5%) The most common indications for reoperation were urinary tract (60.5%), gastrointestinal (7.4%), and gynecologic, i.e., examination under anesthesia (6.2%). Body mass index (BMI) was less (p = 0.001), and operative time (p = 0.014) and length of stay (LOS) (p = 0.001) longer in patients who were readmitted. Those who underwent reoperation had longer LOS than those who did not have reoperation (p < 0.001). Upon multivariate analysis, BMI <25 (all p < 0.05) and longer LOS maintained statistical significance as risk factors for those who experienced readmission or reoperation (p = 0.0406, p < 0001). Conclusions: Isolated MUS placement has low 30-day readmission and reoperation rates. Increased LOS was associated with readmission, while increased LOS and BMI <25 were associated with reoperation within 30 days.

Original languageEnglish (US)
Pages (from-to)1-4
Number of pages4
JournalInternational Urogynecology Journal
DOIs
StateAccepted/In press - Jan 11 2018

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Suburethral Slings
Reoperation
Length of Stay
Body Mass Index
Urinary Tract
Current Procedural Terminology
Patient Readmission
Cystoscopy
Stress Urinary Incontinence
Urinary Retention
Operative Time
Quality Improvement
Multivariate Analysis
Anesthesia
Databases

Keywords

  • Quality improvement readmission
  • Reoperation
  • Sling
  • Urinary incontinence

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Urology

Cite this

Readmission and reoperation after midurethral sling. / Hokenstad, Erik D.; Glasgow, Amy E.; Habermann, Elizabeth B; Occhino, John A.

In: International Urogynecology Journal, 11.01.2018, p. 1-4.

Research output: Contribution to journalArticle

Hokenstad, Erik D. ; Glasgow, Amy E. ; Habermann, Elizabeth B ; Occhino, John A. / Readmission and reoperation after midurethral sling. In: International Urogynecology Journal. 2018 ; pp. 1-4.
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abstract = "Introduction and hypothesis: We aimed to determine the rate of readmission and reoperation for patients undergoing midurethral sling (MUS) placement for stress urinary incontinence (SUI). Methods: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was queried to identify all isolated MUS placed from 2012 through 2015 using the Current Procedural Terminology 4 (CPT-4) code for MUS with or without cystoscopy (57,288 ± 52,000). The cohort was then reviewed for unplanned, related readmissions and reoperations within 30 days of MUS placement. Results: Isolated MUS was placed in 9910 patients. Fifty-eight (0.59{\%}) patients were readmitted and 81 (0.82{\%}) had reoperation. The most common indications for readmission were related to the urinary tract, i.e., urinary retention (27.6{\%}), non-surgical-site-related infection (15.5{\%}), and medical related issues (15.5{\%}) The most common indications for reoperation were urinary tract (60.5{\%}), gastrointestinal (7.4{\%}), and gynecologic, i.e., examination under anesthesia (6.2{\%}). Body mass index (BMI) was less (p = 0.001), and operative time (p = 0.014) and length of stay (LOS) (p = 0.001) longer in patients who were readmitted. Those who underwent reoperation had longer LOS than those who did not have reoperation (p < 0.001). Upon multivariate analysis, BMI <25 (all p < 0.05) and longer LOS maintained statistical significance as risk factors for those who experienced readmission or reoperation (p = 0.0406, p < 0001). Conclusions: Isolated MUS placement has low 30-day readmission and reoperation rates. Increased LOS was associated with readmission, while increased LOS and BMI <25 were associated with reoperation within 30 days.",
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