MP64-06 PREOPERATIVE NUTRITIONAL STATUS AS A PREDICTOR OF RADICAL CYSTECTOMY POST OPERATIVE COMPLICATIONS: A NATIONAL COMPARISON

Abstract

You have accessJournal of UrologyBladder Cancer: Natural History and Pathophysiology1 Apr 2015MP64-06 PREOPERATIVE NUTRITIONAL STATUS AS A PREDICTOR OF RADICAL CYSTECTOMY POST OPERATIVE COMPLICATIONS: A NATIONAL COMPARISON Richard Matulewicz, Apas Aggarwal, John Kim, and Shilajit Kundu Richard MatulewiczRichard Matulewicz More articles by this author , Apas AggarwalApas Aggarwal More articles by this author , John KimJohn Kim More articles by this author , and Shilajit KunduShilajit Kundu More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2317AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Preoperative malnutrition is a concern for patients undergoing radical cystectomy and may influence both medical and surgical complications post operatively. We seek to identify specific complications related to preoperative nutritional deficiency. METHODS The American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) 2005-2012 database was reviewed for all patients undergoing a radical cystectomy based on Current Procedural Terminology (CPT) codes (51570, 51575, 51580, 51585, 51590, 51595, 51596, 51597). Patients with missing data on albumin, height, weight, gender and American Society of Anesthesiology (ASA) class were removed. Patients who had an albumin<3.5 g/dl, BMI<18.5 or displayed >10% weight loss were considered “nutritionally deficient” (ND). All other patients had “normal nutritional status” (NNS). We also stratified post-operative complication by Clavien grade and summed up patients' comorbidites to create a “comorbidity count” variable that was entered into multivariate logistic regression. RESULTS After all exclusions, 1,513 patients underwent a radical cystectomy. Of this cohort, 21.5% (n=325) were nutritionally deficient while 78.5% had normal nutritional status. Specifically, 18% had an albumin<3.5 g/dl, 2.2% had a BMI<18.5, and 4.0% had >10% weight loss. The ND group displayed higher rates of any complication (71.1% vs 58.7%, p=<0.001), Clavien grade 2 (66.8% versus 54.5%, p=<0.001), and Clavien grade 4 (9.5% vs 6.2%, p=0.037) complications. On multivariate regression, after controlling for age, inpatient status, ASA class, total relative value unit (RVU), operation time and comorbidity count, preoperative nutritional deficiency increased risk of any complication (OR 1.788, 95% CI 1.357-2.356, p=<0.001) and Clavien grade 2 complications (OR 1.735, 95% CI 1.328-2.267, p<0.001). CONCLUSIONS Pre-operative nutritional status increases risk of post-operative complications. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e800 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Richard Matulewicz More articles by this author Apas Aggarwal More articles by this author John Kim More articles by this author Shilajit Kundu More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...