MP40-13 PERIOPERATIVE OUTCOMES FOR 6042 NEPHRECTOMIES: SURGEON-REPORTED OUTCOMES RECORDED ON THE BAUS NEPHRECTOMY DATABASE

Abstract

You have accessJournal of UrologyKidney Cancer; Evaluation/Staging IV1 Apr 2014MP40-13 PERIOPERATIVE OUTCOMES FOR 6042 NEPHRECTOMIES: SURGEON-REPORTED OUTCOMES RECORDED ON THE BAUS NEPHRECTOMY DATABASE John Henderson, Sarah Fowler, Adrian Joyce, Andrew Dickinson, and Francis Keeley John HendersonJohn Henderson More articles by this author , Sarah FowlerSarah Fowler More articles by this author , Adrian JoyceAdrian Joyce More articles by this author , Andrew DickinsonAndrew Dickinson More articles by this author , and Francis KeeleyFrancis Keeley More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1348AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives The British Association of Urological Surgeons (BAUS) has collected nephrectomy outcomes through a central database since 2001. The centrally issued guidance mandating the publication of surgeon-specific outcomes by 2013 in the UK increased recording from approximately 30% to 90%. This data for 2012, the first year of reporting,is presented here. Methods All patients treated with nephrectomy in 2012 were identified on the database. Incorrectly coded data was removed or reassigned. Operations were categorised as simple nephrectomy (SN), partial nephrectomy (PN), radical nephrectomy (RN) and nephroureterectomy (NU). The perioperative outcomes were 30-day mortality (30-DM), Clavien-Dindo ≥ Grade III complication, need for intraoperative blood transfusion, conversion to open and length of stay. Results Data for 6042 patients was retrieved (male 59%, female 40%, not specified 1%). After data cleansing, 5954 records were available for analysis. The mean age at operation was 62 years of age (SN 50.0; PN 58.5; RN 63.8; NU 70.6). Minimally invasive surgery was performed in 69% (SN 82.1%; PN 41.5%; RN 70.4%; NU 83.4%). The 30-DM was 0.55% (SN 0.53%; PN 0.10%; RN 0.52%; NU 1.27%). Clavien-Dindo ≥ Grade III complications occurred in 3.9% (SN 4.3%; PN 5.4%; RN 3.1%; NU 4.5%). Conversion to open was required in 5.5% of minimally invasive procedures. The most commonly cited reasons were haemorrhage and difficult dissection . The median length of stay was shorter with minimally invasive (median 4 days) than with open procedures (median 6 days). The transfusion rate was 8.4% (SN 5.2%; PN 3.4%; RN 11.1%; NU 8.4%). Conclusions This data suggest that nephrectomy in the UK in 2012 was performed safely with outcomes comparable or better than published series. There are limitations and potential errors with this data. An estimated ten percent of nephrectomies were not recorded. Self-reported data has the possibility of under reporting complications. Risk-stratification was performed but further refinement is required to reflect case-mix. The large number of cases provides a useful research tool and baseline for comparison of future years. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e439 Advertisement Copyright & Permissions© 2014MetricsAuthor Information John Henderson More articles by this author Sarah Fowler More articles by this author Adrian Joyce More articles by this author Andrew Dickinson More articles by this author Francis Keeley More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...