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

## TL;DR

The study examines rehospitalisation rates and risk factors after prostate cancer surgery in South Australia, identifying factors like age and comorbidities that increase the risk.

## Contribution

The study provides new insights into post-prostatectomy rehospitalisation trends and risk factors using linked data from 2002 to 2021.

## Key findings

- 13% of patients had at least one hospital visit within 90 days post-prostatectomy.
- Older age and higher comorbidity burden were strongly associated with increased rehospitalisation rates.
- Recent treatment periods (2016–2021) showed a 39% lower rehospitalisation rate compared to earlier years.

## Abstract

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).

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.

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.

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.