Evaluation of Short-term Outcomes Following Overlapping Urologic Surgery at a Large Academic Medical Center

• Published in: Urology (Ridgewood, N.J.) Vol. 138; pp. 30 - 36
• Main Authors: Glauser, Gregory, Goodrich, Stephen, McClintock, Scott D., Dimentberg, Ryan, Guzzo, Thomas J., Malhotra, Neil R.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2020
• Subjects: Academic Medical Centers - organization & administration; Academic Medical Centers - statistics & numerical data; Adult; Follow-Up Studies; Hospital Mortality; Humans; Length of Stay - statistics & numerical data; Operating Rooms - organization & administration; Operating Rooms - statistics & numerical data; Operative Time; Patient Readmission - statistics & numerical data; Personnel Staffing and Scheduling - organization & administration; Personnel Staffing and Scheduling - statistics & numerical data; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Reoperation; Retrospective Studies; Surgeons - organization & administration; Surgeons - statistics & numerical data; Treatment Outcome; Urologic Surgical Procedures - adverse effects; Urologic Surgical Procedures - statistics & numerical data
• ISSN: 0090-4295; 1527-9995; 1527-9995
• DOI: 10.1016/j.urology.2019.12.031

To explore the effect of overlapping surgery on the risk of adverse outcomes in urologic surgery. Coarsened exact matching was used to assess the impact of overlap on outcomes among urologic surgical interventions (n = 4853) over 2 years (2013-2015) at 1 health system. Overlap was categorized as any overlap, beginning overlap or end overlap. Study subjects were matched 1:1 on 11 clinically relevant variables. Serious unanticipated events were studied. Four hundred and thirty-four patients had any overlap and were matched (n = 575, a 75.47% match rate). For beginning/end overlap, matched groups were created (n = 108/83 patients, match rate was 83.07/75.45%, respectively). Among matched patients, any overlap did not predict unanticipated return to surgery at 30 or 90 days. Any overlap predicted neither reoperation, readmission, or ER visits at 30 or 90 days. Overlap patients showed no difference in mortality during follow-up. Beginning/end overlap had a similar lack of association with serious unanticipated events. Nonconcurrent overlapping surgery is not associated with adverse outcomes in a large, matched urologic surgery population across 1 academic health system.