Post-prostatectomy rehospitalisation rates and risk factors in South Australian men with prostate cancer: evidence from linked data.

PURPOSE: Prostate cancer is a common malignancy in men, with radical prostatectomy (RP) being a major treatment option. This study investigates post-prostatectomy rehospitalisation rates and risk factors in a cohort of South Australian men who underwent RP from 2002 to 2021 (n = 5105).

METHODS

Post-prostatectomy rehospitalisation rates at 30 and 90 days were measured from hospital discharge data, with reasons determined from ICD-10 codes. Rates per 1000 person-time were estimated, accounting for the length of follow-up. Zero inflated negative binomial regression analyses were used to identify sociodemographic and clinical factors associated with the number of hospital encounters following RP.

RESULTS

Approximately 13% of patients had at least one hospital visit within 90 days post-prostatectomy. Common reasons for early rehospitalisation (within 30 days) were urinary obstruction (3.2%), haematuria (2.6%), and urinary tract infection (2.5%). Older age (aged 75 + vs < 60: incidence rate ratio (IRR) 2.23, 95% CI: 1.88-2.64), highest comorbidity burden (3 + vs 0: IRR 2.33, 95% CI: 1.80-3.01), and high risk clinical characteristics (PSA > 20 vs < 10 ng/mL: IRR 1.67, 95% CI: 1.34-2.08 and Gleason score 9-10 vs < 7: IRR 1.39, 95% CI: 1.06-1.84) were associated with higher rehospitalisation rates. Conversely, men who were treated from 2016-2021 had 39% lower rehospitalisation rates (IRR 0.61, 95% CI: 0.53-0.71) compared with patients treated from 2002-2005.

CONCLUSION

These findings highlight the importance of considering patient characteristics and tailoring post-surgical care plans to minimise rehospitalisation. The reduction in rehospitalisation over time may reflect advancements in surgical techniques, better patient selection or improved surgeon experience.