Impact of Obesity on Perioperative Outcomes at Robotic-assisted and Open Radical Prostatectomy: Results From the National Inpatient Sample

Abstract

ObjectiveTo test the effect of obesity (body mass index ≥30 kg/m2) on perioperative outcomes and total hospital charges at robot-assisted vs open radical prostatectomy (RARP vs ORP). MethodsWithin the National Inpatient Sample database (2008-2015), we identified obese vs nonobese RARP and ORP patients. Estimated annual percent changes, multivariable logistic regression and linear regression models were used. All models were adjusted for clustering and weighted. ResultsOf all, 53,626 (60%) underwent RARP vs 35,757 (40%) underwent ORP. At RARP, 8.6% were obese vs 6.9% at ORP. RARP rate increased significantly over time (12.5%-81.5%). Obesity rate increased significantly over time at both, RARP (5.1%-10.5%) and ORP (5.4%-10.7%). In multivariable logistic regression models, obesity predicted 5 of 11 unfavourable perioperative complications at RARP (odds ratio: 1.6-1.8) and 9 of 11 at ORP (odds ratio: 1.3-2.8). In linear regression models, obesity significantly added to total hospital charges at RARP (740$) and ORP (312$). ConclusionObesity may predispose to higher rates of adverse outcomes at RP. Its effect varies according to surgical approach.