Prostate cancer is a common malignancy in men, with radical prostatectomy (RP) being a major treatment option. This study investigates post-surgical hospitalisation rates and associated factors in a large cohort of South Australian men who underwent RP from 2001 to 2021 (n=5105).

Hospitalisation rates at 30-day, 90-day, and 2-year post-prostatectomy were extracted from hospital discharge data using ICD-10 codes. Rates per 1000 person-time were estimated, accounting for the length of follow-up. Zero inflated negative binomial regression analyses were used to identify sociodemographic and clinical factors associated with the number of hospitalisation encounters.

About 13% of patients had at least one hospital visit within 90-days post-prostatectomy. Common reasons for early rehospitalisation (within 30-days) were urinary obstruction (3.2%), haematuria (2.6%), genitourinary complications (2.5%) and urinary tract infection (2.0%). Rehospitalisation peaked at day six following RP. Older age (aged 75+ vs <60: incidence rate ratio (IRR) 2.23, 95%CI: 1.88–2.64), highest comorbidity burden (3+ vs 0: IRR 2.33, 95%CI: 1.80–3.01), and high risk clinical characteristics (PSA >20 vs <10 ng/mL: IRR 1.67, 95%CI: 1.34–2.08 and Gleason score 9-10 vs <7: IRR 1.39, 95%CI:1.06–1.84) were associated with higher rehospitalisation rates. Conversely, men who were treated from 2016-2021 had 39% lower rehospitalisation rates (IRR 0.61, 95%CI: 0.53–0.71) compared with patients treated from 2001-2005. These findings highlight the importance of considering patient characteristics and tailoring post-surgical care plans to minimise rehospitalisation risks. The observed reduction in readmission rates over time reflects the advancements in surgical techniques, better patient selection or improved surgeon experience.