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subsequent analyses therefore utilized the composite volume. In unadjusted analysis, anesthesiologist volume was associated with 30 day (lowest volume 27% vs highest volume 21%, p¼0.021) and 90 day (lowest volume 39% vs highest volume 31%, p¼0.007) readmission rates. These results persisted in multivariate analysis; lower volume anesthesiologists were associated with higher rates of readmission at 30 days (HR 1.40, 95% CI 1.13-1.75) and 90 days (HR 1.40, 95% CI 1.15-1.70). These findings remained significant after adjusting for both surgeon and hospital volumes in the models. In multivariate analysis, anesthesiologist volumes were not associated with postoperative mortality or 5-year OS and CSS. CONCLUSIONS: The annual volume of RC for any given anesthesiologist was low, reflecting the lack of sub-specialization in urological procedures in routine clinical practice. Readmission rates after RC are significantly increased with lower volume anesthesia providers. Consideration should be given to consolidating anesthesiology providers to enhance case load for similarly complex urological/general surgical procedures.

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