Morbidity and mortality after benign prostatic hyperplasia surgery: data from the American College of Surgeons national surgical quality improvement program
Standard
Morbidity and mortality after benign prostatic hyperplasia surgery: data from the American College of Surgeons national surgical quality improvement program. / Bhojani, Naeem; Gandaglia, Giorgio; Sood, Akshay; Rai, Arun; Pucheril, Daniel; Chang, Steven L; Karakiewicz, Pierre I; Menon, Mani; Olugbade, Kola; Ruhotina, Nedim; Sammon, Jesse D; Sukumar, Shyam; Sun, Maxine; Ghani, Khurshid R; Schmid, Marianne; Varda, Briony; Kibel, Adam S; Zorn, Kevin C; Trinh, Quoc-Dien.
in: J ENDOUROL, Jahrgang 28, Nr. 7, 01.07.2014, S. 831-840.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Morbidity and mortality after benign prostatic hyperplasia surgery: data from the American College of Surgeons national surgical quality improvement program
AU - Bhojani, Naeem
AU - Gandaglia, Giorgio
AU - Sood, Akshay
AU - Rai, Arun
AU - Pucheril, Daniel
AU - Chang, Steven L
AU - Karakiewicz, Pierre I
AU - Menon, Mani
AU - Olugbade, Kola
AU - Ruhotina, Nedim
AU - Sammon, Jesse D
AU - Sukumar, Shyam
AU - Sun, Maxine
AU - Ghani, Khurshid R
AU - Schmid, Marianne
AU - Varda, Briony
AU - Kibel, Adam S
AU - Zorn, Kevin C
AU - Trinh, Quoc-Dien
PY - 2014/7/1
Y1 - 2014/7/1
N2 - BACKGROUND AND PURPOSE: With the aging population, it is becoming increasingly important to identify patients at risk for postsurgical complications who might be more suited for conservative treatment. We sought to identify predictors of morbidity after surgical treatment of benign prostatic hyperplasia (BPH) using a large national contemporary population-based cohort.METHODS: Relying on the American College of Surgeons National Surgical-Quality Improvement Program (ACS-NSQIP; 2006-2011) database, we evaluated outcomes after transurethral resection of the prostate (TURP), laser vaporization of the prostate (LVP), and laser enucleation of the prostate (LEP). Outcomes included blood-transfusion rates, length of stay, complications, reintervention rates, and perioperative mortality. Multivariable logistic-regression analysis evaluated the predictors of perioperative morbidity and mortality.RESULTS: Overall, 4794 (65.2%), 2439 (33.1%), and 126 (1.7%) patients underwent TURP, LVP, and LEP, respectively. No significant difference in overall complications (P=0.3) or perioperative mortality (P=0.5) between the three surgical groups was found. LVP was found to be associated with decreased blood transfusions (odds ratio [OR]=0.21; P=0.001), length of stay (OR=0.12; P<0.001) and reintervention rates (OR=0.63; P=0.02). LEP was found to be associated with decreased prolonged length of stay (OR=0.35; P=0.01). Men with advanced age at surgery and non-Caucasians were at increased risk of morbidity and mortality. In contrast, normal preoperative albumin and higher preoperative hematocrit (>30%) levels were the only predictors of lower overall complications and perioperative mortality.CONCLUSIONS: All three surgical modalities for BPH management were found to be safe. Advanced age and non-Caucasian race were independent predictors of adverse outcomes after BPH surgery. In patients with these attributes, conservative treatment might be a reasonable alternative. Also, preoperative hematocrit and albumin levels represent reliable predictors of adverse outcomes, suggesting that these markers should be evaluated before BPH surgery.
AB - BACKGROUND AND PURPOSE: With the aging population, it is becoming increasingly important to identify patients at risk for postsurgical complications who might be more suited for conservative treatment. We sought to identify predictors of morbidity after surgical treatment of benign prostatic hyperplasia (BPH) using a large national contemporary population-based cohort.METHODS: Relying on the American College of Surgeons National Surgical-Quality Improvement Program (ACS-NSQIP; 2006-2011) database, we evaluated outcomes after transurethral resection of the prostate (TURP), laser vaporization of the prostate (LVP), and laser enucleation of the prostate (LEP). Outcomes included blood-transfusion rates, length of stay, complications, reintervention rates, and perioperative mortality. Multivariable logistic-regression analysis evaluated the predictors of perioperative morbidity and mortality.RESULTS: Overall, 4794 (65.2%), 2439 (33.1%), and 126 (1.7%) patients underwent TURP, LVP, and LEP, respectively. No significant difference in overall complications (P=0.3) or perioperative mortality (P=0.5) between the three surgical groups was found. LVP was found to be associated with decreased blood transfusions (odds ratio [OR]=0.21; P=0.001), length of stay (OR=0.12; P<0.001) and reintervention rates (OR=0.63; P=0.02). LEP was found to be associated with decreased prolonged length of stay (OR=0.35; P=0.01). Men with advanced age at surgery and non-Caucasians were at increased risk of morbidity and mortality. In contrast, normal preoperative albumin and higher preoperative hematocrit (>30%) levels were the only predictors of lower overall complications and perioperative mortality.CONCLUSIONS: All three surgical modalities for BPH management were found to be safe. Advanced age and non-Caucasian race were independent predictors of adverse outcomes after BPH surgery. In patients with these attributes, conservative treatment might be a reasonable alternative. Also, preoperative hematocrit and albumin levels represent reliable predictors of adverse outcomes, suggesting that these markers should be evaluated before BPH surgery.
KW - Age Factors
KW - Aged
KW - Blood Transfusion
KW - Databases, Factual
KW - Hematocrit
KW - Humans
KW - Laser Therapy
KW - Length of Stay
KW - Male
KW - Morbidity
KW - Odds Ratio
KW - Prostatic Hyperplasia
KW - Quality Improvement
KW - Regression Analysis
KW - Reoperation
KW - Serum Albumin
KW - Societies, Medical
KW - Transurethral Resection of Prostate
KW - United States
U2 - 10.1089/end.2013.0805
DO - 10.1089/end.2013.0805
M3 - SCORING: Journal article
C2 - 24517323
VL - 28
SP - 831
EP - 840
JO - J ENDOUROL
JF - J ENDOUROL
SN - 0892-7790
IS - 7
ER -