Predictors of costs for robotic-assisted laparoscopic radical prostatectomy

Christian Bolenz, Amit Gupta, Claus Roehrborn, Yair Lotan

Research output: Contribution to journalReview article

11 Scopus citations

Abstract

Objectives: Information on the association of perioperative parameters with costs for robotic-assisted laparoscopic radical prostatectomy (RALP) is lacking. Understanding factors that impact cost may allow reduction in cost of prostate cancer care. We identified factors associated with higher costs in a contemporary series of RALP. Materials and methods: Total direct cost and clinicopathologic data were available for 264 patients who underwent RALP at our institution between May 2005 and April 2008. We performed linear regression analyses to identify predictors of direct cost using preoperative, intraoperative, and postoperative variables. Results: On univariable analyses, operating room (OR) time, placement of a pelvic drain (both P < 0.001), complications during surgery (P = 0.002) or hospitalization, blood transfusion, and length of stay (all P < 0.001) were associated with higher direct costs. On multivariable analysis, none of the preoperative features were found to predict direct costs. Of the intraoperative factors, OR time (P < 0.001) and pelvic drain placement (P = 0.006) were associated with higher direct costs. A longer OR time, length of stay, and usage of transfusions (all P < 0.001) during the postoperative course were independently associated with higher direct costs. Conclusions: Of factors that are available preoperatively, none seems to be useful to predict added costs for individual patients undergoing RALP. Higher costs for RALP are driven by events occurring during the procedure or postoperative hospital stay.

Original languageEnglish (US)
Pages (from-to)325-329
Number of pages5
JournalUrologic Oncology: Seminars and Original Investigations
Volume29
Issue number3
DOIs
StatePublished - May 1 2011

Keywords

  • Cost analysis
  • Economics
  • Laparoscopy
  • Prostate cancer
  • Prostatectomy
  • Robotics

ASJC Scopus subject areas

  • Oncology
  • Urology

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