MP67-09 PREDICTORS OF WOUND DEHISCENCE IN A PROSPECTIVE DATASET OF 2,556 CYSTECTOMIES

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive IV1 Apr 2015MP67-09 PREDICTORS OF WOUND DEHISCENCE IN A PROSPECTIVE DATASET OF 2,556 CYSTECTOMIES Christian Meyer, Julian Hanske, Deepansh Dalela, Daniel Pucheril, Marianne Schmid, Jesse Sammon, Mani Menon, Felix Chun, Joachim Noldus, Margit Fisch, and Quoc-Dien Trinh Christian MeyerChristian Meyer More articles by this author , Julian HanskeJulian Hanske More articles by this author , Deepansh DalelaDeepansh Dalela More articles by this author , Daniel PucherilDaniel Pucheril More articles by this author , Marianne SchmidMarianne Schmid More articles by this author , Jesse SammonJesse Sammon More articles by this author , Mani MenonMani Menon More articles by this author , Felix ChunFelix Chun More articles by this author , Joachim NoldusJoachim Noldus More articles by this author , Margit FischMargit Fisch More articles by this author , and Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2492AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Wound dehiscence is major complication following radical cystectomy. It is a significant cause of readmission, reopearation and potentially delays lifesaving adjuvant therapies. We sought to investigate the incidence and predictors of wound dehiscence in patients undergoing radical cystectomy. METHODS 2556 patient records with Current Procedural Terminology (CPT) codes for cystectomy between 2005 and 2012 were extracted from the American College of Surgeons National Quality Improvement Program (ACS-NSQIP). Stratification was made on the basis of the occurrence of postoperative wound dehiscence. This was defined as full disintegrity of the skin and fascial layer. Outcomes of interest included overall complication, mortality, prolonged length of stay and prolonged operative time, the latter two defined as measures above the 75th percentile. Descriptive and logistic regression models were performed to identify predictors of postoperative wound dehiscence. RESULTS Of 2556 patients analyzed, 74 (2.9%) had a documented wound dehiscence. In multivariable analyses, smoking (OR 2.2 p=.002), prolonged operative time (OR 1.6;p=0.05) and BMI were associated with increased odds of postoperative wound dehiscences. Female gender was associated with decreased odds of dehiscence (OR 0.4; p=0.022). Elevated preoperative creatinine (>1.2 mg/dl), chronic steroid use and diabetes were not independent predictors. CONCLUSIONS Our study is the first to identify predictors of wound dehiscence following radical cystectomy in a large multi-institutional prospective cohort. Identifying patients at risk for postoperative wound complications may guide the use preventative measures at the time of surgery. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e853 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christian Meyer More articles by this author Julian Hanske More articles by this author Deepansh Dalela More articles by this author Daniel Pucheril More articles by this author Marianne Schmid More articles by this author Jesse Sammon More articles by this author Mani Menon More articles by this author Felix Chun More articles by this author Joachim Noldus More articles by this author Margit Fisch More articles by this author Quoc-Dien Trinh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...