dissection was re-approximated to completely exclude mesh from the abdominal contents. Standard perioperative antibiotics were adminis- tered. Complication rates for patients with > 90 days follow up are reported. RESULTS: Of 29 patients having prophylactic mesh placed, 22 had >90 days follow up (Median¼271 days, IQR 192, 351). Median age of the 12 men and 10 women was 70.9 years. Median BMI was 32 (IQR 30.1, 35.4) and median preoperative albumin level was 4.3 (IQR 4.1, 4.4). 32% had neoadjuvant chemotherapy prior to RC, 23% had prior radiation therapy, and 41% had prior abdominal surgery. Both Turnbull (n¼11) and end-stoma (n¼11) techniques were used for IC formation. Placement of mesh added on average 10:03 minutes of surgical time. There were no mesh infections, fis- tula formation, or conduit strictures identified. Wound complications, including seroma (n¼4) and superficial wound infections (n¼6), were the most frequent, followed by GI (n¼5), Infectious (n¼5), GU (n¼4), Bleeding (n¼4), and Cardiac, Pulmonary, Thromboembolic, and Neurologic (n¼1 each). All wound related complications were managed with bedside drainage and local wound care. No patient had a mesh-related complication and there was no need for mesh removal. CONCLUSIONS: The placement of prophylactic, partially absorbable mesh in patients at high risk for PH formation appears feasible and safe. Wound-related complications were the most frequently seen and were successfully managed with bedside drainage and local wound care. Over a short period of follow up, no fistulas, strictures, or mesh-related complications were identified. Source of Funding: None MP64-12 POSTOPERATIVE ATRIAL FIBRILLATION FOLLOWING RADICAL CYSTECTOMY PREDICTS FUTURE CARDIOVASCULAR EVENTS Robert Blackwell*, Chandy Ellimoottil, Petar Bajic, Matthew Zapf, Anai Kothari, Paul Kuo, Robert Flanigan, Marcus Quek, Gopal Gupta, Maywood, IL INTRODUCTION AND OBJECTIVES: Post-operative atrial fibrillation (POAF) following radical cystectomy is reported to occur in 2-8% of cases. Recent evidence suggests that even transient POAF predicts future cardiovascular (CV) events. The effects of POAF in the radical cystectomy population are largely unknown. METHODS: We used the Healthcare Cost and Utilization Project State Inpatient Database for Florida (2009-2011) to identify patients who underwent radical cystectomy (ICD-9 57.71) and had atrial fibrillation listed as a diagnosis (ICD-9 427.3). We excluded patients with a preexisting diagnosis of atrial fibrillation. Medical comorbidities were identified to compute a CHA 2 DS 2 -VASc score (a validated risk score for atrial fibrillation) for each patient. Inpatient admissions were linked across years to provide long-term follow-up. The primary endpoint was a composite of CV events, including myocardial infarction, pulmonary embolism, stroke, cardiac arrest, or death. CV events were excluded if they occurred during the surgical admission or after 6 months postoperatively. We fit a multivariable mixed-effects logistic regression model to assess the effect of POAF on CV events after adjusting for CHA 2 DS 2 -VASc score. RESULTS: Radical cystectomy was performed in 2,086 pa- tients, of whom 160 had preexisting atrial fibrillation and were excluded. Of the remaining 1,926 patients, 105 (5.5%) developed POAF. POAF patients had a higher mean CHA 2 DS 2 -VASc score (2.9 vs 2.2, p<0.001), were older, and more likely to have a diagnosis of hyper- tension (all p<0.05). CV events were noted in 69 patients (3.6%) during the initial 6-month postoperative period, and occurred more often in those with POAF (10.5 vs 3.2%, c 2 ¼15, p<0.001). Univariate analysis also indicated age >75 years, hypertension, and congestive heart failure all increased the risk for CV event, while age <65 years decreased the risk (all p<0.05). Our multivariable logistic regression model (Table) revealed that POAF was associated with increased risk of a CV event within the first 6 months after surgery (OR 2.8, p¼0.004). CONCLUSIONS: The presence of POAF is independently associated with an increased risk of adverse CV events in the post- operative period. These findings suggest that patients who develop even transient POAF should be monitored closely for at least six months after surgery. Multivariate Analysis Variable OR (95% CI) p value Postoperative Atrial Fibrillation 2.8 (1.4 - 5.5) 0.004 Age < 65 years 0.4 (0.2 - 0.8) 0.008 Age 65 - 75 years 0.6 (0.3 - 1.0) 0.045 Age > 75 years omitted Gender 1.0 (0.6 - 1.8) 0.9 Hypertension 1.6 (0.9 - 2.8) 0.1 Diabetes Mellitus 0.9 (0.5 - 1.5) 0.6 Congestive Heart Failure 2.2 (0.9 - 5.5) 0.09 Peripheral Vascular Disease 1.2 (0.5 - 3.0) 0.7 Source of Funding: none MP64-13 HEALTHCARE-ASSOCIATED INFECTIONS FOLLOWING CYSTECTOMY: ROOM FOR IMPROVEMENT Jesse Sammon*, Dane Klett, Firas Abdollah, Akshay Sood, Daniel Pucheril, Detroit, MI; Julian Hanske, Christian Meyer, Boston, MA; James Peabody, Mani Menon, Detroit, MI; Quoc-Dien Trinh, Bos- ton, MA INTRODUCTION AND OBJECTIVES: Healthcare associated infections (HAI) following cancer surgery impose significant morbidity and mortality, which is largely preventable. With growing awareness of the importance of HAI we hypothesized that rates of HAI mortality would be declining following cystectomy. Accordingly, we examine rates of cystectomy associated HAI, patient and hospital characteristics that may predispose to HAI and examine the effect of HAI on post cys- tectomy mortality. METHODS: Discharge records from patients undergoing cys- tectomy between 1999 and 2009 were abstracted from the Nationwide Inpatient Sample (n¼79,840) and assessed for one of four HAI (UTI, pneumonia, surgical site infection, Sepsis). Generalized linear regres- sion models were used to estimate the impact of the primary predictors on the odds of HAI and in-hospital mortality. Trends in incidence were evaluated with linear regression. RESULTS: Overall 19% of the cystectomy population experi- enced an HAI, of these 8.3% experienced in-hospital mortality. Having an HAI was associated with greatly increased odds of mortality OR 7.03 (95%CI: 5.66-8.73). Whereas overall mortality decreased 2.6% per year, EAPC -2.58(95%CI:-4.89 to -0.26), mortality following HAI saw no improvement EAPC -1.72(95%CI:-4.92 to 1.5). Furthermore cys- tectomy-associated HAI remained stable EAPC 1.53(95%CI:-0.75 to 3.82). Odds of mortality were increased least for UTI OR 2.31 (95%CI: 1.80-2.98) and most for Sepsis OR 15.99 (95%CI: 12.63-20.26). CONCLUSIONS: Though overall cystectomy mortality improved between 1999 and 2009, patients experiencing an HAI failed to see any improvement. Further the incidence of cystectomy-associ- ated HAI remained stable and remained detrimentally linked to mortality during hospitalization. Disparities in HAI incidence and mortality, based on race and insurance coverage, highlight the need for improved ac- cess to quality health care to avoid potentially devastating outcomes because of preventable HAIs. e802 THE JOURNAL OF UROLOGY â Vol. 193, No. 4S, Supplement, Monday, May 18, 2015