Author's Accepted Manuscript Impact of Complications and Hospital-Free Days following Radical Cystectomy on Health-Related Quality of Life at One Year Chad R. Ritch, Michael S. Cookson, Sam S. Chang, Peter E. Clark, Matthew J. Resnick, David F. Penson, Joseph A. Smith Jr., Alex T. May, Christopher B. Anderson, Chaochen You, Haerin Lee, Daniel A. Barocas PII: DOI: Reference:

S0022-5347(14)03739-2 10.1016/j.juro.2014.06.004 JURO 11536

To appear in: The Journal of Urology Accepted Date: 2 June 2014 Please cite this article as: Ritch CR, Cookson MS, Chang SS, Clark PE, Resnick MJ, Penson DF, Smith JA Jr., May AT, Anderson CB, You C, Lee H, Barocas DA, Impact of Complications and HospitalFree Days following Radical Cystectomy on Health-Related Quality of Life at One Year, The Journal of Urology® (2014), doi: 10.1016/j.juro.2014.06.004. DISCLAIMER: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our subscribers we are providing this early version of the article. The paper will be copy edited and typeset, and proof will be reviewed before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to The Journal pertain. All press releases and the articles they feature are under strict embargo until uncorrected proof of the article becomes available online. We will provide journalists and editors with full-text copies of the articles in question prior to the embargo date so that stories can be adequately researched and written. The standard embargo time is 12:01 AM ET on that date.

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Impact of Complications and Hospital-Free Days following Radical Cystectomy on Health-Related Quality of Life at One Year

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Chad R. Ritch1, Michael S. Cookson2, Sam S. Chang1, Peter E. Clark1, Matthew J. Resnick1, David F. Penson1, Joseph A. Smith, Jr.1, Alex T. May1, Christopher B. Anderson1, Chaochen You1, Haerin Lee1, Daniel A. Barocas1. 1

Vanderbilt University Medical Center, Department of Urologic Surgery, Nashville, TN 2

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University of Oklahoma Medical Center, Oklahoma City, OK

Brief Descriptive Running Head: Hospital-free days and radical cystectomy

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Keywords: radical cystectomy, quality of life, length of stay, complications, readmission, hospital-free days

Correspondence to: Chad R. Ritch MD Vanderbilt University Medical Center Department of Urologic Surgery A-1302 Medical Center North Nashville, TN 37232 Telephone: (615) 322-2101 Fax: (615) 322-8990 Email: [email protected]

Word count: 2,498

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ABSTRACT Purpose: We sought to determine the extent to which complications, as well as the number of “hospitalfree days” (HFDs) within 30 and 90 days of surgery predicted HRQOL at one year following radical cystectomy (RC).

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Materials and Methods: We used data from a prospective HRQOL study using a validated instrument, the Vanderbilt Cystectomy Index-15 (VCI-15). Complications were graded by the Clavien system, and hospital length of stay and length of stay during readmissions were used to calculate 30- and 90-day HFDs, respectively. We compared the number of HFDs among patients with varying levels of complications. Multivariable analysis was performed to determine predictors of VCI-15 score one year after surgery adjusting for demographic (age, gender, comorbidities) and clinical variables (stage, and diversion type)).

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Results: A total of 100 patients with complete baseline and one year follow-up HRQOL data were included in the analysis. The median (IQR) 30 and 90-day HFDs were 24 (22-25) and 84 (82-85) days, respectively. Patients who experienced any complications had significantly fewer 30d HFDs (22 vs. 24 days, p

Impact of complications and hospital-free days on health related quality of life 1 year after radical cystectomy.

We determined the extent to which complications as well as number of hospital-free days within 30 and 90 days of surgery predicted health related qual...
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