1751 IN-HOSPITAL MORTALITY AND FAILURE TO RESCUE AFTER RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive (III)1 Apr 20131751 IN-HOSPITAL MORTALITY AND FAILURE TO RESCUE AFTER RADICAL CYSTECTOMY Maxine Sun, Vincent QH Trinh, Hugo Lavigueur-Blouin, Andreas Becker, Florian Roghmann, Zhe Tian, Al'a Abdo, Pierre I Karakiewicz, and Quoc-Dien Trinh Maxine SunMaxine Sun Montreal, Canada More articles by this author , Vincent QH TrinhVincent QH Trinh Montreal, Canada More articles by this author , Hugo Lavigueur-BlouinHugo Lavigueur-Blouin Montreal, Canada More articles by this author , Andreas BeckerAndreas Becker Hamburg, Germany More articles by this author , Florian RoghmannFlorian Roghmann Herne, Germany More articles by this author , Zhe TianZhe Tian Montreal, Canada More articles by this author , Al'a AbdoAl'a Abdo Montreal, Canada More articles by this author , Pierre I KarakiewiczPierre I Karakiewicz Montreal, Canada More articles by this author , and Quoc-Dien TrinhQuoc-Dien Trinh Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2880AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To illustrate underlying variability in perioperative mortality following radical cystectomy (RC) by analyzing failure-to-rescue (FTR) rates, i.e. deaths after complications. METHODS Patients undergoing RC for non-metastatic bladder cancer were identified using the Nationwide Inpatient Sample, between years 1999-2009, resulting in a weighted estimate of 79972 patients. FTR was assessed according to patient and hospital characteristics, as well as types of complications. Generalized linear regression analyses were performed. RESULTS Overall, 26740 patients had a complication, corresponding to a FTR rate of 5.5%. Septicemia (odds ratio [OR]: 10.6, P<0.001), cardiac (OR: 3.1, P<0.001), neurological (OR: 2.0, P<0.001), wound (OR: 1.9, P<0.001), genitourinary (OR: 1.6, P<0.001), hematological (OR: 1.4, P<0.001) and infectious (OR: 1.2, P=0.031) complications were associated with FTR. Older age (OR: 1.06, P<0.001), higher comorbidities (OR: 1.16, P<0.001), Asian races (OR: 1.58, P=0.002), and Medicaid insurance status (OR: 1.72, P=0.004) were associated with higher odds of FTR. Median household income >35,000$ (vs. 1-24,999$ OR: 0.78-0.82, both P≤0.033) indicated lower odds of FTR. Large bed size (vs. small bed size OR: 0.78, P=0.004) and increasing hospital volume (OR: 0.995, P<0.001) showed lower odds of FTR. CONCLUSIONS Whereas both patient and hospital characteristics are accountable for increased odds of FTR, the occurrence of specifically septicemia, cardiac, neurological, wound, genitourinary, hematological or infectious complications results a higher risk of in-hospital mortality. The current analyses confirm the importance of FTR as an indicator of critical care following a high-risk procedure. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e720 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Maxine Sun Montreal, Canada More articles by this author Vincent QH Trinh Montreal, Canada More articles by this author Hugo Lavigueur-Blouin Montreal, Canada More articles by this author Andreas Becker Hamburg, Germany More articles by this author Florian Roghmann Herne, Germany More articles by this author Zhe Tian Montreal, Canada More articles by this author Al'a Abdo Montreal, Canada More articles by this author Pierre I Karakiewicz Montreal, Canada More articles by this author Quoc-Dien Trinh Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...