Christer Groeben1, Rainer Koch2, Martin Baunacke3, Marianne Schmid4, Angelika Borkowetz3, Manfred P Wirth3, Johannes Huber3. 1. Department of Urology, Medical Faculty Carl Gustav Carus, Technical University of Dresden, Dresden, Germany. christer.groeben@uniklinikum-dresden.de. 2. Department of Medical Statistics and Biometry, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany. 3. Department of Urology, Medical Faculty Carl Gustav Carus, Technical University of Dresden, Dresden, Germany. 4. Department of Urology, University Hospital Goettingen, Goettingen, Germany.
Abstract
OBJECTIVE: Our aim was to assess and compare trends of urinary diversion (UD) for patients receiving radical cystectomy for the treatment of bladder cancer in the US and Germany, and to investigate decisive predictors for the choice of UD. METHODS: We analyzed the nationwide German hospital billing database and the Nationwide Inpatient Sample (NIS) from 2006 to 2014. Cases with a bladder cancer diagnosis combined with RC were included, and trends in the choice of UD, transfusion rates, length of stay, and mortality were assessed. RESULTS: From 2006 to 2014, the total number of RCs recorded within the NIS were 17,711, with a varying annual caseload of 1666-2009, while RC numbers increased from 5627 to 7390 in Germany (p < 0.001 for trends), with a total of 60,447 cases. The share of incontinent UD in the US remained stable at 93%, while increasing from 63.2 to 70.8% in Germany. Multivariate models indicated age and sex were the most important factors associated with the choice of UD in both countries, while hospital caseload and teaching status were less relevant factors in the US. In-hospital mortality was lower in the US compared with Germany (1.9% vs. 4.6%; p < 0.001), with significantly shorter hospital stays (10.7 days in the US vs. 25.1 days in Germany; p < 0.001). CONCLUSIONS: The increasing age of patients with presumably higher comorbidity in recent years led to increased use of incontinent UD in Germany, while continent UD appears to be underused in the US. Mortality and transfusion rates were significantly lower in the US within a shorter hospital stay.
OBJECTIVE: Our aim was to assess and compare trends of urinary diversion (UD) for patients receiving radical cystectomy for the treatment of bladder cancer in the US and Germany, and to investigate decisive predictors for the choice of UD. METHODS: We analyzed the nationwide German hospital billing database and the Nationwide Inpatient Sample (NIS) from 2006 to 2014. Cases with a bladder cancer diagnosis combined with RC were included, and trends in the choice of UD, transfusion rates, length of stay, and mortality were assessed. RESULTS: From 2006 to 2014, the total number of RCs recorded within the NIS were 17,711, with a varying annual caseload of 1666-2009, while RC numbers increased from 5627 to 7390 in Germany (p < 0.001 for trends), with a total of 60,447 cases. The share of incontinent UD in the US remained stable at 93%, while increasing from 63.2 to 70.8% in Germany. Multivariate models indicated age and sex were the most important factors associated with the choice of UD in both countries, while hospital caseload and teaching status were less relevant factors in the US. In-hospital mortality was lower in the US compared with Germany (1.9% vs. 4.6%; p < 0.001), with significantly shorter hospital stays (10.7 days in the US vs. 25.1 days in Germany; p < 0.001). CONCLUSIONS: The increasing age of patients with presumably higher comorbidity in recent years led to increased use of incontinent UD in Germany, while continent UD appears to be underused in the US. Mortality and transfusion rates were significantly lower in the US within a shorter hospital stay.
Authors: Hyun Jung Jin; Ji Sung Shim; Tae Gyun Kwon; Tae-Hwan Kim; Seung Hyun Jeon; Sang Hyub Lee; Sung Gu Kang; Jong Kil Nam; Wan Suk Kim; Byung Chang Jeong; Jong Jin Oh; Sang Chul Lee; Ji Youl Lee; Sung-Hoo Hong; Koon Ho Rha; Woong Kyu Han; Won Sik Ham; Young Goo Lee; Yong Seong Lee; Sung Yul Park; Young Eun Yoon; Ja Hyeon Ku; Seok Ho Kang Journal: Investig Clin Urol Date: 2022-01
Authors: Roman Herout; Martin Baunacke; Christer Groeben; Cem Aksoy; Björn Volkmer; Marcel Schmidt; Nicole Eisenmenger; Rainer Koch; Sven Oehlschläger; Christian Thomas; Johannes Huber Journal: World J Urol Date: 2021-08-28 Impact factor: 4.226
Authors: Markus Maier; Anne-Karoline Ebert; Martin Baunacke; Christer Groeben; Nicole Eisenmenger; Christian Thomas; Johannes Huber Journal: Urologe A Date: 2021-09-15 Impact factor: 0.639