Hedong Han1, Yingyi Qin1, Yiming Ruan1, Jia He1,2, Zhexu Cao3, Xin Wei4, Yang Cao5. 1. Department of Health Statistics, Second Military Medical University, Shanghai, China. 2. Tongji University School of Medicine, Shanghai, China. 3. Department of Urology, Shanghai Hospital, Second Military Medical University, Shanghai, China. 4. Department of Cardiology, Virginia Commonwealth University, Richmond, VA, United States. 5. Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.
Abstract
INTRODUCTION: Robot-assisted laparoscopic radical prostatectomy (RALRP) may be more challenging in obese individuals. This study aimed to evaluate whether obesity had an adverse effect on perioperative outcomes following RALRP. METHODS: Hospitalized patients who underwent RALRP from 2008-2014 were identified using the National Inpatient Sample database. We grouped RALRP patients into non-obese, obesity class I-II and obesity class III (morbid obesity). Rates of blood transfusion, intraoperative and postoperative complications, in-hospital mortality, prolonged length of stay, and total costs were compared among the three groups by univariate regression, multivariate regression, and propensity score weighting analysis. RESULTS: Of 53 301 patients identified, 48 725 were non-obese, 3572 were diagnosed with obesity class I-II, and 1004 were diagnosed with morbid obesity. Compared to non-obesity (7.62%), overall postoperative complications were commonly observed in obesity class I-II (10.55%) and morbid obesity (17.11%). Multivariable analyses suggested that morbid obesity was associated with increased overall postoperative (odds ratio [OR] 2.00; 95% confidence interval [CI] 1.65-2.42), cardiac (OR 1.63; 95% CI 1.03-2.58), respiratory (OR 4.03; 95% CI 3.04-5.36), genitourinary (OR 1.77; 95% CI 1.08-2.90), miscellaneous medical (OR 1.94; 95% CI 1.58-2.39) complications, prolonged hospitalization (OR 1.86; 95% CI 1.57-2.21), and 12% higher total cost. Propensity score weighting analysis yielded similar results. Adequate covariate balance was achieved for all variables after weighting. CONCLUSIONS: Morbid obesity is adversely associated with perioperative outcomes in RALRP. Close management is required in patients undergoing RALRP with morbid obesity for potential worse prognosis.
INTRODUCTION: Robot-assisted laparoscopic radical prostatectomy (RALRP) may be more challenging in obese individuals. This study aimed to evaluate whether obesity had an adverse effect on perioperative outcomes following RALRP. METHODS: Hospitalized patients who underwent RALRP from 2008-2014 were identified using the National Inpatient Sample database. We grouped RALRP patients into non-obese, obesity class I-II and obesity class III (morbid obesity). Rates of blood transfusion, intraoperative and postoperative complications, in-hospital mortality, prolonged length of stay, and total costs were compared among the three groups by univariate regression, multivariate regression, and propensity score weighting analysis. RESULTS: Of 53 301 patients identified, 48 725 were non-obese, 3572 were diagnosed with obesity class I-II, and 1004 were diagnosed with morbid obesity. Compared to non-obesity (7.62%), overall postoperative complications were commonly observed in obesity class I-II (10.55%) and morbid obesity (17.11%). Multivariable analyses suggested that morbid obesity was associated with increased overall postoperative (odds ratio [OR] 2.00; 95% confidence interval [CI] 1.65-2.42), cardiac (OR 1.63; 95% CI 1.03-2.58), respiratory (OR 4.03; 95% CI 3.04-5.36), genitourinary (OR 1.77; 95% CI 1.08-2.90), miscellaneous medical (OR 1.94; 95% CI 1.58-2.39) complications, prolonged hospitalization (OR 1.86; 95% CI 1.57-2.21), and 12% higher total cost. Propensity score weighting analysis yielded similar results. Adequate covariate balance was achieved for all variables after weighting. CONCLUSIONS: Morbid obesity is adversely associated with perioperative outcomes in RALRP. Close management is required in patients undergoing RALRP with morbid obesity for potential worse prognosis.
Authors: Mario Rivera-Izquierdo; Javier Pérez de Rojas; Virginia Martínez-Ruiz; Miguel Ángel Arrabal-Polo; Beatriz Pérez-Gómez; José Juan Jiménez-Moleón Journal: Prostate Cancer Prostatic Dis Date: 2022-01-06 Impact factor: 5.455
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Authors: Mario Rivera-Izquierdo; Virginia Martínez-Ruiz; José Juan Jiménez-Moleón Journal: Int J Environ Res Public Health Date: 2022-01-27 Impact factor: 3.390