Статья

Perioperative Complications and In-Hospital Mortality in Paraplegic Radical Cystectomy Patients

Francesco Di BelloCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada. [email protected]Carolin SiechCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, CanadaMario de AngelisCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, CanadaNatali Rodriguez PeñarandaCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, CanadaZhe TianCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, CanadaJordan A. GoyalCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, CanadaClaudia Collà RuvoloDepartment of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, ItalyGianluigi CalifanoDepartment of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, ItalyMassimiliano CretaDepartment of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, ItalyFred SaadCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, CanadaShahrokh F. ShariatDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, AustriaAlberto BrigantiDivision of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, ItalyFelix K. H. ChunDepartment of Urology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, GermanySalvatore MicaliDepartment of Urology, Ospedale Policlinico e Nuovo Ospedale Civile S. Agostino Estense Modena, University of Modena and Reggio Emilia, Modena, ItalyNicola LongoDepartment of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, ItalyPierre I. KarakiewiczCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada

2024en

ABI

Аннотация

OBJECTIVE: The aim of this study was to test for the association between paraplegia and perioperative complications as well as in-hospital mortality after radical cystectomy (RC) for non-metastatic bladder cancer. METHODS: Perioperative complications and in-hospital mortality were tabulated in RC patients with or without paraplegia in the National Inpatient Sample (2000-2019). RESULTS: Of 25,527 RC patients, 185 (0.7%) were paraplegic. Paraplegic RC patients were younger (≤70 years of age; 75 vs. 53%), more frequently female (28 vs. 19%), and more frequently harbored Charlson Comorbidity Index ≥3 (56 vs. 18%). Of paraplegic vs. non-paraplegic RC patients, 141 versus 15,112 (76 vs. 60%) experienced overall complications, 38 versus 2794 (21 vs. 11%) pulmonary complications, 36 versus 3525 (19 vs. 14%) genitourinary complications, 33 versus 3087 (18 vs. 12%) intraoperative complications, 21 versus 1035 (11 vs. 4%) infections, and 17 versus 1343 (9 vs. 5%) wound complications, while 62 versus 6267 (34 vs. 25%) received blood transfusions, 47 versus 3044 (25 vs. 12%) received critical care therapy (CCT), and intrahospital mortality was recorded in 13 versus 456 (7.0 vs. 1.8%) patients. In multivariable logistic regression models, paraplegic status independently predicted higher overall CCT use (odds ratio [OR] 2.1, p < 0.001) as well as fourfold higher in-hospital mortality (p < 0.001), higher infection rate (OR 2.5, p < 0.001), higher blood transfusion rate (OR 1.45, p = 0.009), and higher intraoperative (OR 1.56, p = 0.02), wound (OR 1.89, p = 0.01), and pulmonary (OR 1.72, p = 0.004) complication rates. CONCLUSION: Paraplegic patients contemplating RC should be counseled about fourfold higher risk of in-hospital mortality and higher rates of other untoward effects.

Перевод пока недоступен

Идентификаторы

DOI: 10.1245/s10434-024-16332-3

Цитирования и источники

Цитирований: 2Использованных источников: 0

Показатели — AkademScholar