INTRODUCTION: More elderly patients are presenting for surgical consultation. Understanding the risk of mortality by age group after urological surgery is important for patient selection and counselling. METHODS: A historical cohort study of The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database from 2006-2015 was performed. Current procedural terminology (CPT) codes for similar surgical procedures were grouped for analyses. Urological procedures commonly performed in elderly patients were identified and stratified by patient age and surgical approach (open vs. laparoscopic/robotic). The primary outcome was the absolute risk of death by 30 days stratified by age for each surgical procedure. The secondary outcome was risk of death by surgical approach (open vs. laparoscopic/robotic). RESULTS: Twelve urological procedures were reviewed including 124 262 patients. A total of 1011 (0.8%) deaths occurred by 30 days after surgery. The procedure with the highest incidence of mortality by 30 days was open nephroureterectomy (2.9 %). In patients 80 years and over, the procedure with the highest incidence of death was open radical nephrectomy (5.32%). There was an increased risk of mortality with increasing age group for all procedures. Unadjusted risk of mortality was consistently higher in patients who receive open compared to laparoscopic surgery. CONCLUSIONS: There is an increasing risk of mortality with age and with open surgical approach in urology. Knowledge regarding the absolute risk of mortality in patients receiving common urological surgeries may improve patient selection and counselling.
INTRODUCTION: More elderly patients are presenting for surgical consultation. Understanding the risk of mortality by age group after urological surgery is important for patient selection and counselling. METHODS: A historical cohort study of The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database from 2006-2015 was performed. Current procedural terminology (CPT) codes for similar surgical procedures were grouped for analyses. Urological procedures commonly performed in elderly patients were identified and stratified by patient age and surgical approach (open vs. laparoscopic/robotic). The primary outcome was the absolute risk of death by 30 days stratified by age for each surgical procedure. The secondary outcome was risk of death by surgical approach (open vs. laparoscopic/robotic). RESULTS: Twelve urological procedures were reviewed including 124 262 patients. A total of 1011 (0.8%) deaths occurred by 30 days after surgery. The procedure with the highest incidence of mortality by 30 days was open nephroureterectomy (2.9 %). In patients 80 years and over, the procedure with the highest incidence of death was open radical nephrectomy (5.32%). There was an increased risk of mortality with increasing age group for all procedures. Unadjusted risk of mortality was consistently higher in patients who receive open compared to laparoscopic surgery. CONCLUSIONS: There is an increasing risk of mortality with age and with open surgical approach in urology. Knowledge regarding the absolute risk of mortality in patients receiving common urological surgeries may improve patient selection and counselling.
Authors: S F Khuri; J Daley; W Henderson; K Hur; J Demakis; J B Aust; V Chong; P J Fabri; J O Gibbs; F Grover; K Hammermeister; G Irvin; G McDonald; E Passaro; L Phillips; F Scamman; J Spencer; J F Stremple Journal: Ann Surg Date: 1998-10 Impact factor: 12.969
Authors: C A Polanczyk; E Marcantonio; L Goldman; L E Rohde; J Orav; C M Mangione; T H Lee Journal: Ann Intern Med Date: 2001-04-17 Impact factor: 25.391
Authors: Hiten D Patel; Mark W Ball; Jason E Cohen; Max Kates; Phillip M Pierorazio; Mohamad E Allaf Journal: Urology Date: 2015-03 Impact factor: 2.649
Authors: Daniel Liberman; Giovanni Lughezzani; Maxine Sun; Ahmed Alasker; Rodolphe Thuret; Firas Abdollah; Lars Budaus; Hugues Widmer; Markus Graefen; Francesco Montorsi; Shahrokh F Shariat; Paul Perrotte; Pierre I Karakiewicz Journal: Urology Date: 2011-01-22 Impact factor: 2.649
Authors: Diana Magee; Douglas Cheung; Amanda Hird; Srikala S Sridhar; Charles Catton; Peter Chung; Alejandro Berlin; Padraig Warde; Alexandre Zlotta; Neil Fleshner; Girish S Kulkarni Journal: Can Urol Assoc J Date: 2022-04 Impact factor: 2.052