Table 4 Outcome data for impact evaluation of perioperative hospitalist service for urologic procedures
Prostatectomy pre-program | Prostatectomy post-program | Nephrectomy pre-program | Nephrectomy post-program | Cystectomy pre-program | Cystectomy post-program | |
|---|---|---|---|---|---|---|
A. Unmatched data comparisons | ||||||
Primary outcome | ||||||
N | 72 | 125 | 65 | 90 | 26 | 46 |
Length of stay (days) median (25/75 interval) | 1.5 (1–2) | 1 (1–2) | 4 (3–5) | 3 (2–3) | 9 (8–13.5) | 7 (5.25–8.75) |
Bed days saved (mean difference - days) | 0.27 | 1.3 | 3.1 | |||
Length of stay p value | 0.058 | < 0.001 | < 0.001 | |||
Secondary outcome | ||||||
Percentage of total complications (total complications/amount of opportunities for complications) | 4.8% | 1.5% | 9.8% | 6.3% | 7.0% | 3.6% |
AKI | 2.8% | 0.8% | 4.6% | 3.3% | 7.7% | 2.2% |
DVT | 0 | 0 | 0 | 0 | 0 | 0 |
Myocardial infarction | 4.2% | 1.6% | 4.6% | 4.4% | 0 | 0 |
Pneumonia | 0 | 0.8% | 1.5% | 1.1% | 3.8% | 0 |
Pulmonary embolus | 0 | 0 | 1.5% | 0 | 0 | 0 |
Sepsis | 0 | 0 | 0 | 0 | 0 | 0 |
Stroke | 0 | 0 | 0 | 0 | 0 | 2.2% |
Surgical site infection | 0 | 0 | 0 | 0 | 0 | 0 |
UTI | 0 | 0 | 0 | 0 | 0 | 2.2% |
Erectile dysfunction | 0 | 0 | 0 | 0 | 0 | 0 |
Ileus | 45.8% | 13.6% | 95.3% | 57.8% | 65.4% | 32.6% |
Ileus Incidence p value | < 0.001 | < 0.001 | < 0.001 | |||
Return of flatus (POD) median (25/75 interval) | 2 (1–2) | 2 (1–2) | 4 (3–4) | 3 (3–4) | 5 (5–6) | 4 (3–5) |
p value | 0.422 | 0.029 | < 0.001 | |||
Percentage of subjects with consultations | 5.6% | 6.4% | 29.3% | 12.2% | 38.5% | 32.6% |
% Change direct cost (standard error of estimate) | − 0.12% (2.75) | −14.55% (3.00) | −11.83% (7.52) | |||
p value | 0.555 | 0.306 | 0.172 | |||
B. Propensity matched data comparisons | ||||||
Primary outcome | ||||||
N | 71 | 71 | 64 | 64 | 23 | 23 |
Length of stay (days) median (25/75 interval) | 2 (1–2) | 1 (1–2) | 4 (3–5) | 3 (2–3) | 9 (8–13.5) | 7 (5–10) |
Bed says saved (mean difference - days) | 0.44 | 1.3 | 3.6 | |||
Length of stay p value | 0.009 | < 0.001 | 0.009 | |||
Secondary outcome | ||||||
Percentage of total complications (total complications/amount of opportunities for complications) | 4.6% | 1.0% | 9.8% | 6.4% | 7.1% | 2.0% |
AKI | 2.8% | 1.4% | 4.7% | 3.1% | 8.7% | 4.3% |
DVT | 0 | 0 | 0 | 0 | 0 | 0 |
Myocardial infarction | 2.8% | 1.4% | 4.7% | 6.3% | 0 | 0 |
Pneumonia | 0 | 1.4% | 1.6% | 1.6% | 4.3% | 0 |
Pulmonary embolus | 0 | 0 | 1.6% | 0 | 0 | 0 |
Sepsis | 0 | 0 | 0 | 0 | 0 | 0 |
Stroke | 0 | 0 | 0 | 0 | 0 | 4.3% |
Surgical site infection | 0 | 0 | 0 | 0 | 0 | 0 |
UTI | 0 | 0 | 0 | 0 | 0 | 4.3% |
Erectile Dysfunction | 0 | 0 | 0 | 0 | 0 | 0 |
Ileus | 45% | 7% | 95.3% | 59.4% | 65.2% | 8.7% |
Ileus Incidence p value | < 0.001 | < 0.001 | < 0.001 | |||
Return of flatus (POD) median (25/75 interval) | 2 (1–2) | 2 (1–2) | 4 (3–4) | 3 (3–4) | 5 (5–6.75) | 4 (3–4.5) |
p value | 0.854 | 0.005 | < 0.001 | |||
Percentage of subjects with consultations | 5.6% | 2.8% | 29.7% | 17.2% | 34.8% | 13% |
% Change direct cost (standard error of estimate) | − 5.59% (2.54) | − 15.88% (3.18) | − 22.15% (6.21) | |||
p value | 0.317 | 0.277 | 0.075 | |||