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Old age, female gender, BMI predict use of discharge resources after radical cystectomy

31 Aug 2017

The predictors of increased use of discharge resources following radical cystectomy are older age, female gender, length of stay, comorbidities, incontinent diversion and body mass index (BMI), a recent study has found.

To test the hypothesis that patient discharge needs after radical cystectomy are affected by health literacy, researchers identified 504 patients who underwent radical cystectomy and completed the validated Brief Health Literacy Screen (BHLS) after November 2010.

Researchers also performed bivariate and logistic regression analyses to determine whether health literacy is associated with the use of discharge resources after radical cystectomy.

About half (50.6 percent) of patients treated with radical cystectomy required discharge services and had lower health literacy compared with patients discharged home without services (BHLS, 11.9 vs 12.5; p=0.016).

Multivariable analysis showed that older age (odds ratio [OR], 1.1, 95 percent CI, 1.0 to 1.1; p=0.002), female gender (OR, 2.3; 1.2 to 4.4; p=0.019), BMI (OR, 1.1; 1.0 to 1.1; p=0.034), Charlson comorbidity index score (OR, 1.1; 1.0 to 1.2; p=0.037) and length of stay (OR, 1.1; 1.0 to 1.2; p=0.019) significantly correlated with the use of discharge resources.

Patients with continent vs incontinent urinary diversion were less likely to need discharge services after radical cystectomy (OR, 0.4; 0.2 to 0.08; p=0.013).

“Low health literacy may affect patient discharge disposition, but it was not significant on multivariable analysis,” according to researchers. “Factors that influence the complex self-care required of patients after cystectomy should be considered during discharge planning.”

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