Hari T Vigneswaran1, Patrick Lec1, Joseph Brito2, George Turini2, Gyan Pareek3, Dragan Golijanin3. 1. 1 Warren Alpert Medical School of Brown University , Providence, Rhode Island. 2. 2 Division of Urology, Rhode Island Hospital, Warren Alpert Medical School of Brown University , Providence, Rhode Island. 3. 3 Section of Minimally Invasive Urology, Warren Alpert Medical School of Brown University , Providence, Rhode Island.
Abstract
INTRODUCTION: The American Urological Association (AUA) guidelines recommend partial nephrectomy (PN) as the gold standard for treatment of small renal masses (SRMs). This study examines the change in utilization of partial and radical nephrectomies at teaching and nonteaching institutions from 2003 to 2012. MATERIALS AND METHODS: The data sample for this study came from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from 2003 to 2012. International Classification of Diseases, Ninth Revision and Clinical Modification codes were used to identify patients undergoing PN and radical nephrectomy for renal masses limited to the renal parenchyma. Teaching hospitals were defined, but not limited to any institution with an American Medical Association-approved residency program. Linear regression, bivariate, multivariate, and odds ratio analysis were used to demonstrate statistical significance. RESULTS: 39,685 patients were identified in teaching hospitals, and 22,239 were identified in nonteaching hospitals. Prior to the 2009 AUA guidelines, cumulative rates of PN were 33% vs 20% in teaching vs nonteaching hospitals (p < 0.0001) compared with postguideline rates of 48% vs 33% in teaching vs nonteaching hospitals (p < 0.0001). CONCLUSIONS: During the 10-year study period, the use of PN to treat SRMs has significantly increased in both teaching hospitals and in nonacademic centers; however, these changes are occurring at a slower rate in nonteaching hospitals.
INTRODUCTION: The American Urological Association (AUA) guidelines recommend partial nephrectomy (PN) as the gold standard for treatment of small renal masses (SRMs). This study examines the change in utilization of partial and radical nephrectomies at teaching and nonteaching institutions from 2003 to 2012. MATERIALS AND METHODS: The data sample for this study came from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from 2003 to 2012. International Classification of Diseases, Ninth Revision and Clinical Modification codes were used to identify patients undergoing PN and radical nephrectomy for renal masses limited to the renal parenchyma. Teaching hospitals were defined, but not limited to any institution with an American Medical Association-approved residency program. Linear regression, bivariate, multivariate, and odds ratio analysis were used to demonstrate statistical significance. RESULTS: 39,685 patients were identified in teaching hospitals, and 22,239 were identified in nonteaching hospitals. Prior to the 2009 AUA guidelines, cumulative rates of PN were 33% vs 20% in teaching vs nonteaching hospitals (p < 0.0001) compared with postguideline rates of 48% vs 33% in teaching vs nonteaching hospitals (p < 0.0001). CONCLUSIONS: During the 10-year study period, the use of PN to treat SRMs has significantly increased in both teaching hospitals and in nonacademic centers; however, these changes are occurring at a slower rate in nonteaching hospitals.
Authors: Milan Hora; Viktor Eret; Ivan Trávníček; Kristýna Procházková; Tomáš Pitra; Olga Dolejšová; Ondřej Hes; Fredrik Petersson Journal: Cent European J Urol Date: 2016-09-22
Authors: Noor Nabi Junejo; Sultan Saud Alkhateeb; Majed Faisal Alrumayyan; Khalid Yusuf Alkhatib; Hassan Messfer Alzahrani; Mohammed Faihan Alotaibi; Khalid Ibrahim Alothman; Turki Omar Al-Hussain; Waleed Mohamed Altaweel Journal: Urol Ann Date: 2021-03-04