Centralisation of Care for Prevalent Urological Malignancies: The Case for Prostate Cancer

Outcomes after cystectomy in Australian rural and metropolitan hospitals by intensive care admissions

OBJECTIVES

To examine demographics and in-hospital outcomes for patients admitted to Australian intensive care units (ICUs) following cystectomy of the urinary bladder. Additionally, to compare outcomes between metropolitan and rural hospitals.

PATIENTS AND METHODS

A retrospective cohort analysis was undertaken of all adult patients admitted to participating Australian ICUs (Australian and New Zealand Intensive Care Society Adult Patient Database) following cystectomy/cystoprostatectomy between January 2011 and December 2021. The primary outcome was in-hospital mortality. Secondary outcomes were ICU and hospital length of stay.

RESULTS

Over the 10-year period, 3376 adult patients were admitted to 135 Australian ICUs after cystectomy. Of these, 3083 patients (91.3%) were treated in 106 metropolitan ICUs and 293 patients (8.7%) were treated in 29 rural ICUs. There was no difference in adjusted mortality between metropolitan and rural hospitals admitted to an ICU after cystectomy (odds ratio 1.32, 95% confidence interval 0.44-3.48; P = 0.6).

CONCLUSION

There was no difference in in-hospital mortality for cystectomy patients requiring ICU admission between metropolitan and rural hospitals. These findings may be used to inform decisions about the rural provision of cystectomy services.