141 New Guidelines to Reduce Unnecessary Blood Tests, Delayed Discharge and Costs Following Robot Assisted Radical Prostatectomy

نویسندگان

چکیده

Abstract Objectives Routine postoperative blood tests (POBT) following robot assisted radical prostatectomy (RARP) are used to evaluate the impact of surgery on pre-existing co-morbidities and detect early complications. This practice dates back an era open surgery, when loss complication rates were higher. We propose new guidelines improve specificity POBT. Method The cases 1040 consecutive patients who underwent a primary or salvage RARP at two large tertiary urology centres in United Kingdom retrospectively reviewed form guidelines. prospectively validated sample 300 patients. Results Derivation Dataset: 3% 5% had intra- post-operative Clavien-Dindo complications, respectively. 15% clinical concerns postoperatively. 0.9% required perioperative transfusion. 78% routine without concerns, none whom developed complication. 98% complications suspected by judgement. 6% discharge delay ≥ 1 day due delayed incomplete tests. Validation No significant difference existed complication, concern transfusion between derivation validation datasets. Number POBT requested reduced 73% (p < 0.001). improved sensitivity for from 100% 0% 74%. Discharge delays = 0.008). Cost savings £178 per patient. Conclusions Postoperative rare. indication unnecessary inefficient. A guideline-based approach can reduce costs optimise compromising patient safety care.

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ژورنال

عنوان ژورنال: British Journal of Surgery

سال: 2021

ISSN: ['1365-2168', '0007-1323']

DOI: https://doi.org/10.1093/bjs/znab259.1070