Abstract
Based on a questionnaire survey (collection rate: 60%) regarding the perioperative management of radical prostatectomy (RP) in 1,213 educational institutions of the Japanese Urological Association, this study investigates the relationship between critical pathway usage, several perioperative management settings and institutional backgrounds.
A critical pathway was frequently used in the Chugoku-Shikoku districts and in hospitals having 401 beds or more, 3 or more urologists and/or 31 or more beds for urology and also used more frequently as the number of annual RP increases. But it was infrequently used in hospitals having 10 or less beds for urology, not having a computerized medical system or not having an ICU and/or Department of Anesthesia.
Logistic regression analysis demonstrated six significant backgrounds affecting critical pathway usage:district (Tokai-Hokuriku, Chugoku-Shikoku), university hospital, 7 or more urologists, annual RP rate of 11 or more patients, computerized medical system and ICU. Standard deviations were very large, although critical pathway usage provided significant early initiation of walking and oral food intake significantly shortened the period of intravenous and parenteral prophylactic antibiotic administration, provided significant early removal of drain and urethral catheter and significantly shortened hospitalization. District, the number of urologists and annual number of RP affected the majority of the ten perioperative settings on multiple regression analysis. Perioperative management of RP can currently not be standardized in Japan, because each hospital operates with individual critical pathways.
