LOS for TURP – pro
Transurethral resection of prostate (TURP) is among the top 10 surgical conditions that account for hospital admissions. It is a standard of care approach for benigh prostatic hypertorphy. Bed utilization for TURP is an increasing concern in current times. Methods: Trends in TURP were studied using ICD-9-CM coded Victorian hospital morbidity data from public hospitals from 1987/88 to 1994/95. Detailed morbidity data from the same source for the financial year 1995/96 were used to study predictors of LOS by logistic regression. Results: Length of stay decreased significantly between 1987 and 1995 from 10.6 to 6.1 days. The strongest predictor of increased LOS was admission through the emergency room (odds ratio (OR) 14.7; 95% confidence interval (CI) 11.8–18.3). Other significant predictors were older age, lower socio-economic status, presence of comorbid conditions, occurrence of procedural morbidity, and hospital type and location. More recent data suggests that LOS around the country is now about 3.5 days. There is data suggesting that early removal of the Foley can farther reduce the length of stay ithout increased mobidity. When this is done LOS can be reduced to as littel as two days postop; however, while implemented in many hopsitals in the UK, this ahs not been widely accepted in the USA. The LS of 4 days falls within the usual range in the USA.
E.J Mueller MD, Private Practice, E.J Zeidman MD, Private Practice, P.M Desmond MD [Deceased], I.M Thompson MD, Chief, Department of Surgery, S.A Optenberg Dr. PH, Senior Stastician, J Wasson MD, Professor (1996) Reduction of length of stay and cost of transurethral resection of the prostate by early catheter removal BJU International 78 (6), 893–896.
http://www.innovationinurology.nhs.uk/pathways/prostate/follow_up/wolverhampton/case_study.htm