(HealthDay News) – There has been a shift from inpatient to outpatient surgery for commonly performed urological procedures, which has coincided with increasing rates of failure to rescue (FTR) mortality, according to a study published online August 19 in BJU International.

Jesse D. Sammon, DO, from Henry Ford Health System in Detroit, and colleagues utilized data from the Nationwide Inpatient Sample to identify the discharges of all patients undergoing urological surgery between 1998–2010. Both overall and FTR mortality (death after a complication that was potentially recognizable and preventable) were assessed.

The researchers found that an estimated 7,725,736 urological surgeries requiring hospitalization were performed over the study period. There was a 0.63% annual decline in admissions for urological surgery (P=0.008). There was a slight decrease in the odds of overall mortality (odds ratio, 0.990; 95% confidence interval, 0.988–0.993); however, the odds of mortality attributable to FTR increased 5% every year (odds ratio, 1.050; 95% confidence interval, 1.038–1.062). Significant independent predictors of FTR mortality included age, race, Charlson Comorbidity Index, public insurance status, as well as urban hospital location (P<0.001).

“These strata of high-risk individuals represent ideal targets for process improvement initiatives,” the authors write.

One author disclosed financial ties to the pharmaceutical and medical device industries.

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