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

Jessica A Paynter; Zakary Doherty; Kirby R Qin; David Pilcher; Janelle Brennan

doi:10.1111/bju.16642

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

BJU Int. 2025 Jan 16. doi: 10.1111/bju.16642. Online ahead of print.

Authors

Jessica A Paynter^{1

2}, Zakary Doherty^{1

3}, Kirby R Qin^{1

2

4}, David Pilcher^{3

5

6}, Janelle Brennan^{1

2}

Affiliations

¹ Monash Rural Health, Monash University, Bendigo, Victoria, Australia.
² Department of Urology, Bendigo Health, Bendigo, Victoria, Australia.
³ Department of Intensive Care, Alfred Health, Melbourne, Victoria, Australia.
⁴ Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
⁵ The Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resource Evaluation, Melbourne, Victoria, Australia.
⁶ The Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

PMID: 39821421
DOI: 10.1111/bju.16642

Abstract

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.

Keywords: Australia; ICU; Rural; bladder cancer; cystectomy; cystoprostatectomy; national study; radical.