Updated assessment of neobladder utilization and morbidity according to urinary diversion after radical cystectomy: A contemporary US-population-based cohort
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Updated assessment of neobladder utilization and morbidity according to urinary diversion after radical cystectomy: A contemporary US-population-based cohort. / Roghmann, Florian; Becker, Andreas; Trinh, Quoc-Dien; Djahangirian, Orchidee; Djahagirian, Orchidee; Tian, Zhe; Meskawi, Malek; Shariat, Shahrokh F; Graefen, Markus; Karakiewicz, Pierre; Noldus, Joachim; Sun, Maxine.
In: CUAJ-CAN UROL ASSOC, Vol. 7, No. 9-10, 2013, p. E552-60.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Updated assessment of neobladder utilization and morbidity according to urinary diversion after radical cystectomy: A contemporary US-population-based cohort
AU - Roghmann, Florian
AU - Becker, Andreas
AU - Trinh, Quoc-Dien
AU - Djahangirian, Orchidee
AU - Djahagirian, Orchidee
AU - Tian, Zhe
AU - Meskawi, Malek
AU - Shariat, Shahrokh F
AU - Graefen, Markus
AU - Karakiewicz, Pierre
AU - Noldus, Joachim
AU - Sun, Maxine
PY - 2013
Y1 - 2013
N2 - BACKGROUND: In this paper, we examine contemporary utilization rates and determinants of neobladder (NB) after radical cystectomy (RC) relative to ileal conduit (IC), as well as provide an updated assessment of postoperative morbidity and mortality between NB and IC.METHODS: Relying on the Nationwide Inpatient Sample (NIS), we abstracted patients who underwent RC between 2000 and 2010. Subsequently, NB and IC recipients were identified. Use of NB was assessed after accounting for case-mix. Propensity-based matched analyses were used to account for treatment selection biases. Generalized linear regression analyses focused on intra- and postoperative complications, prolonged length of stay, blood transfusions and in-hospital mortality.RESULTS: The utilization rate of NB was 6.9% in 2000 and 9.1% in 2010 (p < 0.001). Younger, healthier, privately-insured and wealthier male individuals were more likely to receive a NB. High-volume hospitals were more likely to offer NB. In the post-propensity matched cohort, urinary diversion type failed to be significantly associated with the examined endpoints, except for intra- and postoperative complications (IC vs. NB odds ratio [OR]: 1.15, p = 0.04).INTERPRETATION: Despite comparable morbidity and mortality odds between NB and IC, as of the most contemporary year of the study (2010), IC remains the preferred urinary diversion type. Several sociodemographic factors were associated with NB.
AB - BACKGROUND: In this paper, we examine contemporary utilization rates and determinants of neobladder (NB) after radical cystectomy (RC) relative to ileal conduit (IC), as well as provide an updated assessment of postoperative morbidity and mortality between NB and IC.METHODS: Relying on the Nationwide Inpatient Sample (NIS), we abstracted patients who underwent RC between 2000 and 2010. Subsequently, NB and IC recipients were identified. Use of NB was assessed after accounting for case-mix. Propensity-based matched analyses were used to account for treatment selection biases. Generalized linear regression analyses focused on intra- and postoperative complications, prolonged length of stay, blood transfusions and in-hospital mortality.RESULTS: The utilization rate of NB was 6.9% in 2000 and 9.1% in 2010 (p < 0.001). Younger, healthier, privately-insured and wealthier male individuals were more likely to receive a NB. High-volume hospitals were more likely to offer NB. In the post-propensity matched cohort, urinary diversion type failed to be significantly associated with the examined endpoints, except for intra- and postoperative complications (IC vs. NB odds ratio [OR]: 1.15, p = 0.04).INTERPRETATION: Despite comparable morbidity and mortality odds between NB and IC, as of the most contemporary year of the study (2010), IC remains the preferred urinary diversion type. Several sociodemographic factors were associated with NB.
U2 - 10.5489/cuaj.221
DO - 10.5489/cuaj.221
M3 - SCORING: Journal article
C2 - 24069095
VL - 7
SP - E552-60
JO - CUAJ-CAN UROL ASSOC
JF - CUAJ-CAN UROL ASSOC
SN - 1911-6470
IS - 9-10
ER -