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Functional Status in Patients Requiring Nursing Home Stay After Radical Cystectomy.
Urology. 2018 11; 121:39-43.U

Abstract

OBJECTIVE

To evaluate the ability to perform activities of daily living (ADLs) in patients who required nursing home (NH) care after radical cystectomy (RC), as this surgery can impair patients' ability to perform ADLs in the postoperative period.

METHODS

Patients undergoing RC were identified in a novel database of patients with at least two NH assessments linked with Medicare inpatient claims. The NH assessment included the Minimum Data Set (MDS)-ADL Long Form (0-28; a higher score equals greater impairment), which quantifies ADLs. Paired t-tests and chi-squared analysis were used for comparisons.

RESULTS

We identified 471 patients that underwent RC and had at least one MDS-ADL assessment. In total, 245 patients lived elsewhere prior to RC and went to an NH after RC, while 122 patients lived in an NH before and after RC. Mean age of the population was 80.7 years (standard deviation 5.7). Of the 245 patients who did not live in a facility before RC, 68% of patients were discharged directly to an NH and 31% were discharged to another location before NH. There was no difference in MDS-ADL score between these groups (16.4 vs 15.0, P = .09). Among the patients who lived in an NH before and after RC, the mean pre- and post-operative MDS-ADL scores were significantly different (12.1 vs 16.6, P<.0001).

CONCLUSION

ADLs, as measured by the MDS-ADL Long Form score, worsen after RC. This should be an important part of the risks and benefits conversation with patients, their families, and caregivers.

Links

PMC Free PDF

Authors+Show Affiliations

Murray KS
Department of Surgery, Division of Urology, University of Missouri, Columbia, MO.
Prunty M
University of Missouri School of Medicine, Columbia, MO.
Henderson A
Department of Surgery, Division of Urology, University of Missouri, Columbia, MO.
Haden T
Department of Surgery, Division of Urology, University of Missouri, Columbia, MO.
Pokala N
Department of Surgery, Division of Urology, University of Missouri, Columbia, MO.
Ge B
Office of Medical Research, University of Missouri, Columbia, MO.
Wakefield M
Department of Surgery, Division of Urology, University of Missouri, Columbia, MO.
Petroski GF
Office of Medical Research, University of Missouri, Columbia, MO.
Mehr DR
Department of Family and Community Medicine, University of Missouri, Columbia, MO.
Kruse RL
Department of Family and Community Medicine, University of Missouri, Columbia, MO.

MeSH

Activities of Daily LivingAgedAged, 80 and overCystectomyDatabases, FactualFemaleGeriatric AssessmentHomes for the AgedHumansLength of StayMaleMedicareNursing HomesPatient Outcome AssessmentPostoperative PeriodRisk AssessmentUnited StatesUrinary Bladder Neoplasms

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30076943

Citation

Murray, Katie S., et al. "Functional Status in Patients Requiring Nursing Home Stay After Radical Cystectomy." Urology, vol. 121, 2018, pp. 39-43.
Murray KS, Prunty M, Henderson A, et al. Functional Status in Patients Requiring Nursing Home Stay After Radical Cystectomy. Urology. 2018;121:39-43.
Murray, K. S., Prunty, M., Henderson, A., Haden, T., Pokala, N., Ge, B., Wakefield, M., Petroski, G. F., Mehr, D. R., & Kruse, R. L. (2018). Functional Status in Patients Requiring Nursing Home Stay After Radical Cystectomy. Urology, 121, 39-43. https://doi.org/10.1016/j.urology.2018.07.030
Murray KS, et al. Functional Status in Patients Requiring Nursing Home Stay After Radical Cystectomy. Urology. 2018;121:39-43. PubMed PMID: 30076943.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Functional Status in Patients Requiring Nursing Home Stay After Radical Cystectomy. AU - Murray,Katie S, AU - Prunty,Megan, AU - Henderson,Alex, AU - Haden,Tyler, AU - Pokala,Naveen, AU - Ge,Bin, AU - Wakefield,Mark, AU - Petroski,Gregory F, AU - Mehr,David R, AU - Kruse,Robin L, Y1 - 2018/08/01/ PY - 2018/05/22/received PY - 2018/06/25/revised PY - 2018/07/20/accepted PY - 2018/8/5/pubmed PY - 2019/5/9/medline PY - 2018/8/5/entrez SP - 39 EP - 43 JF - Urology JO - Urology VL - 121 N2 - OBJECTIVE: To evaluate the ability to perform activities of daily living (ADLs) in patients who required nursing home (NH) care after radical cystectomy (RC), as this surgery can impair patients' ability to perform ADLs in the postoperative period. METHODS: Patients undergoing RC were identified in a novel database of patients with at least two NH assessments linked with Medicare inpatient claims. The NH assessment included the Minimum Data Set (MDS)-ADL Long Form (0-28; a higher score equals greater impairment), which quantifies ADLs. Paired t-tests and chi-squared analysis were used for comparisons. RESULTS: We identified 471 patients that underwent RC and had at least one MDS-ADL assessment. In total, 245 patients lived elsewhere prior to RC and went to an NH after RC, while 122 patients lived in an NH before and after RC. Mean age of the population was 80.7 years (standard deviation 5.7). Of the 245 patients who did not live in a facility before RC, 68% of patients were discharged directly to an NH and 31% were discharged to another location before NH. There was no difference in MDS-ADL score between these groups (16.4 vs 15.0, P = .09). Among the patients who lived in an NH before and after RC, the mean pre- and post-operative MDS-ADL scores were significantly different (12.1 vs 16.6, P<.0001). CONCLUSION: ADLs, as measured by the MDS-ADL Long Form score, worsen after RC. This should be an important part of the risks and benefits conversation with patients, their families, and caregivers. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/30076943/Functional_Status_in_Patients_Requiring_Nursing_Home_Stay_After_Radical_Cystectomy_ DB - PRIME DP - Unbound Medicine ER -