PD29-04 PREDICTORS OF DEEP INCISIONAL AND ORGAN/SPACE SURGICAL SITE INFECTION FOLLOWING RADICAL CYSTECTOMY: RESULTS FROM THE ACS NSQIP SURGICAL REGISTRY

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD29-04 PREDICTORS OF DEEP INCISIONAL AND ORGAN/SPACE SURGICAL SITE INFECTION FOLLOWING RADICAL CYSTECTOMY: RESULTS FROM THE ACS NSQIP SURGICAL REGISTRY Ruben Blachman-Braun, Aaron A. Gurayah, Matthew M Mason, Helen Y Hougen, Mark L Gonzalgo, Bruno Nahar, Sanoj Punnen, Dipen J Parekh, and Chad R. Ritch Ruben Blachman-BraunRuben Blachman-Braun More articles by this author , Aaron A. GurayahAaron A. Gurayah More articles by this author , Matthew M MasonMatthew M Mason More articles by this author , Helen Y HougenHelen Y Hougen More articles by this author , Mark L GonzalgoMark L Gonzalgo More articles by this author , Bruno NaharBruno Nahar More articles by this author , Sanoj PunnenSanoj Punnen More articles by this author , Dipen J ParekhDipen J Parekh More articles by this author , and Chad R. RitchChad R. Ritch More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003315.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical cystectomy (RC) with urinary diversion is the standard treatment for muscle-invasive and persistent high-risk treatment-refractory non–muscle-invasive bladder cancer. Surgical site infection (SSI) is a serious postoperative complication following RC. The objective of this study is to evaluate clinical risk factors associated with postoperative deep incisional or organ/space SSIs following RC in a contemporary cohort of patients using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) surgical registry METHODS: Using the ACS NSQIP surgical registry from 2015-2020, we selected patients≥18 years that had the diagnosis of bladder cancer and underwent RC with incontinent urinary diversion (ileal conduit) or RC with continent urinary diversion. Clinical, demographic, type of surgical approach, and reports of 30-day postoperative deep incisional or organ/space SSIs were assessed. Statistical analysis was performed with SPSS v.28. A p-value <0.05 was considered statistically significant. RESULTS: A total of 13,081 patients were analyzed, 1,061 (8.1%) with deep incisional or organ/space SSI. Of these patients, 11,021 (84.3%) patients underwent RC with incontinent urinary diversion and 2,060 (15.7%) underwent continent urinary diversion. Overall, 10,696 (81.8%) patients were male, age was 69±9.7 years, BMI was 28.5±5.7 kg/m2, diabetes mellitus prevalence was 2,534 (19.4%), and patients classified as functionally independent before surgery was 12,858 (98.3%). On multivariable-adjusted Cox regression analysis, presence of obesity (HR=1.60, 95% CI: 1.35-1.90), diabetes mellitus (HR=1.30, 95% CI: 1.13-1.51), being partially or totally dependent before surgery (HR=2.09, 95% CI: 1.44-3.03), and RC with continent urinary diversion approach (HR=1.61, 95% CI: 1.38-1.88) were associated with a higher risk of deep incisional or organ/space SSI postoperatively (Figure). CONCLUSIONS: Patients with obesity, diabetes mellitus, functional dependence before surgery, or those who underwent RC with a continent urinary diversion approach have a higher risk of developing postoperative deep incisional or organ/space SSIs following RC. Source of Funding: No © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e825 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ruben Blachman-Braun More articles by this author Aaron A. Gurayah More articles by this author Matthew M Mason More articles by this author Helen Y Hougen More articles by this author Mark L Gonzalgo More articles by this author Bruno Nahar More articles by this author Sanoj Punnen More articles by this author Dipen J Parekh More articles by this author Chad R. Ritch More articles by this author Expand All Advertisement PDF downloadLoading ...