PURPOSE Patients treated with radical cystectomy experience a high rate of postoperative complications and frequent hospital readmissions. We sought to explore the utility of the Care Assessment Need (CAN) score, derived from electronic health data, to estimate the risk of these adverse clinical outcomes, thereby aiding patient counseling and informed treatment decision-making. MATERIALS AND METHODS We retrospectively examined data from 982 patients with bladder cancer who underwent radical cystectomy between 2013 and 2018 within the national Veterans Health Administration system. We tested for associations between the preoperative CAN score and length of stay, discharge location, and readmission rates. RESULTS We observed a correlation between higher CAN scores and longer hospital stays (adjusted relative risk = 1.03 [95% CI: 1.02-1.05]). An increased CAN score was also linked to greater odds of discharge to a skilled nursing facility or death (adjusted odds ratio = 1.16 [95% CI: 1.06-1.26]). Furthermore, the score was associated with hospital readmission at both 30 and 90 days postdischarge (adjusted HR = 1.03 [95% CI: 1.00-1.07] and 1.04 [95% CI: 1.00-1.07], respectively). CONCLUSIONS The CAN score is associated with length of hospital stay, discharge to a skilled nursing facility, and readmission within 30 and 90 days after radical cystectomy. These findings highlight the potential of health care systems leveraging electronic health records for automatically calculating multidimensional tools, such as the CAN score, to identify patients at risk of adverse clinical outcomes after radical cystectomy.

中文翻译：

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自动电子健康记录评分，用于估计接受膀胱癌根治性膀胱切除术患者的住院时间和再入院时间。


目的 接受根治性膀胱切除术治疗的患者术后并发症发生率高，再入院率高。我们试图探索来自电子健康数据的护理评估需求 （CAN） 评分的效用，以估计这些不良临床结果的风险，从而帮助患者咨询和明智的治疗决策。材料和方法 我们回顾性检查了 982 年至 2013 年间在国家退伍军人健康管理系统内接受根治性膀胱切除术的 2018 名膀胱癌患者的数据。我们测试了术前 CAN 评分与住院时间、出院地点和再入院率之间的关联。结果 我们观察到较高的 CAN 评分与更长的住院时间之间存在相关性 （调整后的相对风险 = 1.03 [95% CI： 1.02-1.05]）。CAN 评分升高也与出院到专业护理机构或死亡的几率增加有关 （调整后的比值比 = 1.16 [95% CI： 1.06-1.26]）。此外，该评分与出院后 30 天和 90 天的再入院相关 （校正 HR = 1.03 [95% CI： 1.00-1.07] 和 1.04 [95% CI： 1.00-1.07]）。结论 CAN 评分与根治性膀胱切除术后住院时间、出院至专业护理机构以及再入院 30 至 90 天内相关。这些发现强调了医疗保健系统利用电子健康记录自动计算多维工具（例如 CAN 评分）的潜力，以识别根治性膀胱切除术后有不良临床结果风险的患者。