THE IMPACT OF PSYCHIATRIC DIAGNOSES ON PERIOPERATIVE OUTCOMES FOLLOWING RADICAL CYSTECTOMY IN THE STATE OF FLORIDA

You have accessJournal of UrologyCME1 May 2022MP42-11 THE IMPACT OF PSYCHIATRIC DIAGNOSES ON PERIOPERATIVE OUTCOMES FOLLOWING RADICAL CYSTECTOMY IN THE STATE OF FLORIDA Bryce Baird, Tiara Taylor, Shalmali Borkar, Laura Geldmaker, Christian Ericson, Emily Brennan, Augustus Anderson, Stephen Boorjian, Shehzad Niazi, Dorin Colibaseanu, Aaron Spaulding, and Timothy Lyon Bryce BairdBryce Baird More articles by this author , Tiara TaylorTiara Taylor More articles by this author , Shalmali BorkarShalmali Borkar More articles by this author , Laura GeldmakerLaura Geldmaker More articles by this author , Christian EricsonChristian Ericson More articles by this author , Emily BrennanEmily Brennan More articles by this author , Augustus AndersonAugustus Anderson More articles by this author , Stephen BoorjianStephen Boorjian More articles by this author , Shehzad NiaziShehzad Niazi More articles by this author , Dorin ColibaseanuDorin Colibaseanu More articles by this author , Aaron SpauldingAaron Spaulding More articles by this author , and Timothy LyonTimothy Lyon More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002608.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Psychiatric diagnoses, including anxiety and depression, diagnosed after radical cystectomy (RC) for bladder cancer have been linked to increased risks of suicide, cancer-specific and all-cause mortality. However, the potential impact of psychiatric diagnoses on postoperative healthcare resource utilization are less well-understood. Herein, we sought to identify associations between psychiatric diagnoses and perioperative outcomes following RC within the state of Florida. METHODS: The Florida Hospital Inpatient Data File was queried to identify patients who underwent RC between 2013-2019. The exposure was defined as an ICD-10 code for a mood or anxiety disorder and analyzed as a 3-level variable: no mood or anxiety disorder, either a mood or anxiety disorder, and both a mood and anxiety disorder. Outcomes analyzed included inpatient mortality (death or discharge to hospice), non-home discharge, in-hospital complications, and length of stay. Mixed-effects logistic regression accounting for patients clustered within hospitals were used for categorical outcomes and negative binomial regression models were utilized for continuous outcomes. RESULTS: A total of 4396 RC patients were identified, of whom 306 (7.0%) had a mood disorder, and 389 (8.8%) had an anxiety disorder. After adjusting for age, sex, comorbidity, payer, patient region, surgical approach, and average facility volume, patients with either a mood or anxiety disorder (OR 1.49, 95% CI 1.12-1.98) and both a mood and anxiety disorder (OR 2.79, 95% CI 1.73-4.50) had significantly increased odds of discharge to a non-home facility. Additionally, either a mood or anxiety disorder (IRR 1.13, 95% CI 1.07-1.19) and both a mood and anxiety disorder (IRR 1.12, 95% CI 1.01-1.24) were significantly associated with increased length of stay. There were no significant associations between mood and/or anxiety disorders with inpatient mortality or the presence or number of postoperative complications. CONCLUSIONS: In the state of Florida, patients with mood and/or anxiety disorders undergoing RC for bladder cancer had an increased length of stay and increased odds of discharge to a non-home facility, but no difference in the risk of perioperative complications. Differences in behavioral or socioeconomic factors may underlie the observed differences in outcome. These data may be helpful to guide perioperative resource planning in caring for RC patients with psychiatric diagnoses. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e734 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bryce Baird More articles by this author Tiara Taylor More articles by this author Shalmali Borkar More articles by this author Laura Geldmaker More articles by this author Christian Ericson More articles by this author Emily Brennan More articles by this author Augustus Anderson More articles by this author Stephen Boorjian More articles by this author Shehzad Niazi More articles by this author Dorin Colibaseanu More articles by this author Aaron Spaulding More articles by this author Timothy Lyon More articles by this author Expand All Advertisement PDF downloadLoading ...