CAN score predicts length of stay, readmission in patients undergoing radical cystectomy

In patients undergoing radical cystectomy for bladder cancer, an automated electronic health record score (the Care Assessment Need [CAN] score) can estimate the length of hospital stay (LOS), discharge to a skilled nursing facility, and readmission within 30 and 90 days after the procedure, reports a study. 

Data were retrospectively analysed from 982 patients with bladder cancer who underwent radical cystectomy between 2013 and 2018 within the national Veterans Health Administration system. The investigators then explored the associations between the preoperative CAN score and LOS, discharge location, and readmission rates. 

Higher CAN scores correlated with longer hospital stays (adjusted relative risk, 1.03, 95 percent confidence interval [CI], 1.02–1.05), as well as with a higher likelihood of being discharged to a skilled nursing facility (adjusted odds ratio, 1.16, 95 percent CI, 1.06–1.26). 

In addition, the CAN score significantly correlated with hospital readmission at both 30 and 90 days postdischarge (30 days: adjusted hazard ratio [HR], 1.03, 95 percent CI, 1.00–1.07; 90 days: adjusted HR, 1.04, 95 percent CI, 1.00–1.07). 

“These findings highlight the potential of healthcare 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,” the investigators said.  

For context, patients undergoing radical cystectomy often have a high chance of postoperative complications and frequent hospital readmissions.