Abstracts from the Abstracts from the Mid-Atlantic Section of the AUA 2021

© The Canadian Journal of Urology TM : International Supplement, October 2021 Same-Day Discharge and Post-discharge Outcomes after Robot-assisted Radical Prostatectomy L. Xia, R. Talwar, R. Chelluri, D. Lee, T. Guzzo Division of Urology, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, Philadelphia, PA, USA Introduction and Objective: Several high-volume centers have reported their institutional experience on same-day discharge after robot-assisted radical prostatectomy (RARP). There is still limited data available on the risk of readmission and post-discharge complications after RARP at the national level. Methods: Patients who underwent RARP for prostate cancer were identified from the 2012-2019 National Surgical Quality Improvement Program (NSQIP) database. Patients were stratified into two groups: those whowere discharged the day of surgery (same-day discharge, SDD) and those whowere discharged on postoperative day 1 (routine discharge, RD). Outcomes of interest included any post-discharge complications, major post-discharge complications, and unplanned readmission within 30 days of surgery. Results: A total of 41,076 patients (SDD=532, RD=40,544) were included. Overall post-discharge complication rate in the cohort was 3.8% and major post-discharge complication rate was 2.1%. The unplanned readmission rate was 3.2%. Unadjusted analyses showed no significant differences in any post-discharge complications, major post-discharge complications, or unplanned readmission between the two groups (Figure). There were also no significant differences in individual complications between the two groups. Multivariable logistic regression showed that compared with RD, SDD was not associated with increased odds of any post-discharge complications (odds ratio [OR]=1.16, 95% confidence interval [CI]=0.76-1.75, P= 0.493), any post-discharge major complications (OR=1.05, 95%CI=0.59-1.87, P=0.862), or readmission (OR=0.75, 95%CI=0.43-1.31, P= 0.309). Conclusions: Our study adds to the literature showing that SDD after RARP for selected patients is safe and is not associated with increased risks of post- discharge adverse outcomes. Further efforts are needed to identify patients that are candidates for SDD so to decrease health care costs. DP-20 Display Posters Widening of Socioeconomic Disparities After the USPSTF’s 2012 Prostate- Specific Antigen-Based Prostate Cancer Screening Recommendation I. Kim, Jr. 1 , D. Kim 1 , S. Kim 2 , T. Jang 2 , E. Singer 2 , S. Ghodoussipour 2 , M. Aron 3 , I. Kim 2 1 Brown University, Providence, RI, USA; 2 Rutgers, The State University of New Jersey, New Brunswick, NJ, USA; 3 University of Southern California, Los Angeles, CA, USA Introduction and Objective: In 2012, the U.S. Preventive Services Task Force (USPSTF) recommended against prostate-specific antigen (PSA)-based screening for prostate cancer. Previous studies have found that patients of higher socioeconomic status with prostate cancer have better outcomes than those with lower socioeconomic status. In this study, we examined the recommendation’s effects on survival disparities based on socioeconomic, marital, and housing status. Methods: Using the SEER 18 database, we examined prostate cancer- specific survival (PCSS) based on diagnostic time period (2010-2012 for pre- USPSTF era and 2014-2016 for post) and one of three factors: socioeconomic quintile, marital status, and housing (urban/rural). The SEER-designated socioeconomic quintile was based on variables including median household income, rent, and education index. PCSS was measured with the Kaplan- Meier method, while disparities were measured with Cox proportional hazards model. Results: During the pre-USPSTF era, patients in the lowest socioeconomic quintile experienced worse PCSS compared to those in the highest quintile (Table 1; adjusted HR 1.44, 95%CI 1.25-1.67, p<0.01). This survival disparity narrowed during the post-USPSTF era as result of disproportionately decreased PCSS among patients in the lowest quintile (Fig 1; aHR 1.38, 95%CI 1.13-1.69, p<0.01). In contrast, the survival disparity based on marital status widened, while housing status was not associated with survival disparities in either era. Conclusions: From the pre- to post-USPSTF era, the survival disparity among patients based on socioeconomic quintile narrowed, suggesting that the 2012 PSA screening recommendation may have disproportionately hindered patients in the highest socioeconomic quintile from being regularly screened for prostate cancer. DP-19 54