Impact of Age on Perioperative Outcomes at Radical Prostatectomy: A Population-Based Study
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Impact of Age on Perioperative Outcomes at Radical Prostatectomy: A Population-Based Study. / Preisser, Felix; Mazzone, Elio; Nazzani, Sebastiano; Knipper, Sophie; Tian, Zhe; Mandel, Philipp; Pompe, Raisa; Saad, Fred; Montorsi, Francesco; Shariat, Shahrokh F; Huland, Hartwig; Graefen, Markus; Tilki, Derya; Karakiewicz, Pierre I.
in: EUR UROL FOCUS, Jahrgang 6, Nr. 6, 15.11.2020, S. 1213-1219.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Impact of Age on Perioperative Outcomes at Radical Prostatectomy: A Population-Based Study
AU - Preisser, Felix
AU - Mazzone, Elio
AU - Nazzani, Sebastiano
AU - Knipper, Sophie
AU - Tian, Zhe
AU - Mandel, Philipp
AU - Pompe, Raisa
AU - Saad, Fred
AU - Montorsi, Francesco
AU - Shariat, Shahrokh F
AU - Huland, Hartwig
AU - Graefen, Markus
AU - Tilki, Derya
AU - Karakiewicz, Pierre I
N1 - Copyright © 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.
PY - 2020/11/15
Y1 - 2020/11/15
N2 - BACKGROUND: Radical prostatectomy (RP) represents one standard of care for patients with localized prostate cancer and is associated with several established postoperative complications.OBJECTIVE: We tested the relationship between RP early postoperative outcomes and age within a population-based data repository.DESIGN, SETTING, AND PARTICIPANTS: Within the National Inpatient Sample database (2008-2013), we identified patients who underwent robotically assisted or open RP.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Multivariable logistic regression (MLR), multivariable Poisson regression (MPR), and linear regression models were used. Cubic spline graphically depicted the relationship between age and complications.RESULTS AND LIMITATIONS: Overall, 68780 patients underwent RP with a median age of 62 yr (interquartile range: 57-67 yr). In MLR models, patient age represented an independent predictor of overall [odds ratio (OR): 1.02, p<0.001], intraoperative (OR: 1.03, p<0.001), cardiac (OR: 1.03, p<0.001), miscellaneous medical (OR: 1.02, p<0.001), miscellaneous surgical (OR: 1.01, p=0.01), pulmonary (OR: 1.02, p<0.001), and vascular complications (OR: 1.05, p<0.001); blood transfusions (OR: 1.02, p<0.001); and bowel obstruction (OR: 1.02, p<0.001). In MPR models, patient age was associated with longer stay (OR: 1.001, p=0.02). Similar results were recorded after adjustment for clustering in stratified analyses (<70 vs ≥70 yr) and in the subgroup of patients that underwent robotically assisted RP. For nine out of twelve examined outcomes, a virtually direct relationship existed with increasing age, in cubic spline analyses.CONCLUSIONS: Virtually all early postoperative RP complications are directly related to age. In consequence, these observations should be considered from an individual patient perspective as well as from a health management perspective.PATIENT SUMMARY: RP is provided through a wide patient age spectrum. Virtually all early postoperative RP complications are directly related to age. Individual patient's age needs to be considered in treatment decision-making.
AB - BACKGROUND: Radical prostatectomy (RP) represents one standard of care for patients with localized prostate cancer and is associated with several established postoperative complications.OBJECTIVE: We tested the relationship between RP early postoperative outcomes and age within a population-based data repository.DESIGN, SETTING, AND PARTICIPANTS: Within the National Inpatient Sample database (2008-2013), we identified patients who underwent robotically assisted or open RP.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Multivariable logistic regression (MLR), multivariable Poisson regression (MPR), and linear regression models were used. Cubic spline graphically depicted the relationship between age and complications.RESULTS AND LIMITATIONS: Overall, 68780 patients underwent RP with a median age of 62 yr (interquartile range: 57-67 yr). In MLR models, patient age represented an independent predictor of overall [odds ratio (OR): 1.02, p<0.001], intraoperative (OR: 1.03, p<0.001), cardiac (OR: 1.03, p<0.001), miscellaneous medical (OR: 1.02, p<0.001), miscellaneous surgical (OR: 1.01, p=0.01), pulmonary (OR: 1.02, p<0.001), and vascular complications (OR: 1.05, p<0.001); blood transfusions (OR: 1.02, p<0.001); and bowel obstruction (OR: 1.02, p<0.001). In MPR models, patient age was associated with longer stay (OR: 1.001, p=0.02). Similar results were recorded after adjustment for clustering in stratified analyses (<70 vs ≥70 yr) and in the subgroup of patients that underwent robotically assisted RP. For nine out of twelve examined outcomes, a virtually direct relationship existed with increasing age, in cubic spline analyses.CONCLUSIONS: Virtually all early postoperative RP complications are directly related to age. In consequence, these observations should be considered from an individual patient perspective as well as from a health management perspective.PATIENT SUMMARY: RP is provided through a wide patient age spectrum. Virtually all early postoperative RP complications are directly related to age. Individual patient's age needs to be considered in treatment decision-making.
U2 - 10.1016/j.euf.2018.12.006
DO - 10.1016/j.euf.2018.12.006
M3 - SCORING: Journal article
C2 - 30594487
VL - 6
SP - 1213
EP - 1219
JO - EUR UROL FOCUS
JF - EUR UROL FOCUS
SN - 2405-4569
IS - 6
ER -
