Estimated length of stay calculated by “diagnosisrelated groups” in patients with prostate cancer: a retrospective analysis

ABSTRACT

Introduction: To evaluate whether the presence of bone metastasis in hospitalized patients with prostate cancer (PCa) is associated with a longer length of stay (LOS) when compared to LOS estimated by diagnosis-related groups (DRG). Methods: We performed a retrospective analysis of 86 admissions of patients with PCa at our facility in 2018-2019. Admissions were divided into two groups based on actual LOS and LOS estimated by DRG: group 1 (actual LOS=DRG-LOS) and group 2 (actual LOS<DRG-LOS). The association of bone metastasis and other variables with increased LOS was evaluated by logistic regression with univariable and multivariable analysis, controlling baseline patient characteristics. Results: Longer LOS was not associated with baseline characteristics (age, body mass index, and presence of comorbidities), but was significantly associated with type of admission and ICU (intensive care unit) admission during hospitalization (p<0.05). Bone metastasis was observed in 28 (68.3%) of group 2 admissions and was independently associated with increased LOS (group 2) on univariable and multivariable analysis (OR=4.76, 95% CI=1.91-11.8, p=0.001; OR=3.48, 95% CI=1.08-11.2, p=0.03, respectively). Conclusion: Among clinical or surgical admissions of patients with PCa over a 1-year period, presence of bone metastasis was independently associated with increased LOS when compared to LOS estimated by DRG. The presence of bone metastasis may be used to identify possible outliers not recognized by the DRG system.

RESUMO

Introdução: Avaliar se a presença de metástases ósseas em pacientes hospitalizados com câncer de próstata (CaP) está associada a um maior tempo de internação (TI) quando comparado ao LOS estimado por grupos de diagnóstico relacionados (GDRs). Métodos: Realizamos uma análise retrospectiva de 86 admissões de pacientes com CaP em nosso serviço em 20182019. As admissões foram divididas em dois grupos com base no TI real e no TI estimado pelo GDR: grupo 1 (TI real=GDR-TI) e grupo 2 (TI real<GDR-TI). A associação de metástases ósseas e outras variáveis com TI aumentada foi avaliada por regressão logística com análise univariável e multivariável, controlando as características basais do paciente. Resultados: O tempo de permanência prolongado não foi associado às características basais (idade, índice de massa corporal e presença de comorbidades), mas foi significativamente associado ao tipo de admissão e à admissão na UTI (unidade de terapia intensiva) durante a internação (p<0.05). Metástase óssea foi observada em 28 (68,3%) das admissões do grupo 2 e foi independentemente associada com aumento do TI (grupo 2) na análise univariável e multivariável (OR=4,76, IC 95%=1,91-11,8, p=0,001; OR=3,48, IC 95%=1,08-11,2, p=0,03, respectivamente). Conclusão: Entre as internações clínicas ou cirúrgicas de pacientes com CaP ao longo de um período de 1 ano, a presença de metástases ósseas foi independentemente associada ao aumento do TI em comparação com o TI estimado pelo GDR. A presença de metástases ósseas pode ser usada para identificar possíveis outliers não reconhecidos pelo sistema GDR.

Keywords:

Prostatic neoplasm - Diagnostic-related groups - Bone metastasis - Length of stay.

Descritores:

Neoplasia prostática - Grupos de diagnósticos relacionados - Metástase óssea - Tempo de permanência.

Publication History

Received: 01 August 2020

Accepted: 18 March 2021

Article published online:
14 May 2021

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