Disparities in neighborhood deprivation and patient reported quality of life relating to post-operative sequelae after radical cystectomy.

141 Background: Readmissions following radical cystectomy(RC) remain high despite prehabilitation and enhanced recovery after surgery (ERAS) care. Recently, studies have shown the correlation between socioeconomic neighborhood deprivation (ND) and post-operative quality of life (QoL) in oncologic surgeries. We sought to examine the impact of preoperative QoL and ND with postoperative sequela following RC. Methods: This was a prospective IRB approved study of patients undergoing RC for bladder cancer from 2021 to 2023. QoL was assessed with the FACT-Bl-Cys survey. Clinicopathologic, complication, and readmission data were collected up to 90 days, as well as distance from the hospital and 4 zip-code based Indices (1-100 index scores representing socioeconomic deprivation). FACT-BL-Cys and indices scores were correlated with outcomes of interest. Pairwise Spearman correlation was done between indices and QoL Instruments. A multivariable analysis (MVA) identified the factors that influence complications and readmissions. Results: The cohort consisted of 56 patients, mostly men (n=40, 71%). Median age was 69, most had organ-confined disease (≤(y)pT2N0M0, n =45, 80%) and underwent neoadjuvant chemotherapy (n=32, 57%). 75% underwent a continent diversion (neobladder n=38, 68% or continent cutaneous diversion n=4, 7%). Median follow-up time was 10.1 months (range 3.7 - 16.7 months). No correlation was observed between 30/90-day complications or readmissions with FACT-BL-Cys. Healthy Places Index (HPI) correlated with overall QoL and subscores. On MVA, correlation was seen between Social Deprivation Index (SDI) and 90-day readmissions (p=0.03, OR=0.97, 95%CI= 0.94-0.99). Conclusions: Patient-reported QoL aligns with diverse socioeconomic strata, as per deprivation indices, which in turn correlate with readmissions. Further studies are needed to understand the relationship between patient reported QoL and ND with postoperative outcomes. Correlation between zip code-based deprivation indexes and quality of life scores. Well Being Scores Distance to Hospital HPI DCI SDI Physical 0.35 (p=0.01) 0.28 (p=0.05) -0.22 (p=0.11) -0.15 (p=0.27) Social 0.00 (p= 0.97) 0.10 (p=0.46) -0.11 (p=0.40) -0.10 (p=0.49) Emotional -0.07 (p=0.62) -0.18 (p=0.21) 0.19 (p=0.15) 0.22 (p=0.11) Functional 0.28 (p=0.04) 0.36 (p=0.01 ) -0.26 (p=0.05) -0.16 (p=0.24) BL-CYS 0.13 (p=0.36) 0.23 (p=0.10) -0.11 (p=0.42) -0.04 (p=0.79) TOI (PWB+FWB+BL-CYS) 0.26 (p=0.06) 0.34 (p=0.01) -0.22 (p=0.10) -0.13 (p=0.33) FACT-BL-CYS Total Score 0.19 (p=0.16) 0.31 (p=0.03) -0.20 (p=0.13) -0.11 (p=0.42) HPI: Healthy Places Index, DCI: Distressed Communities Index, SDI: Social Deprivation Index, ADI: Area Deprivation Index.