You have accessJournal of UrologyCME1 Apr 2023MP48-08 30-DAY, 90-DAY, AND 1-YEAR COMPLICATIONS FOLLOWING MAJOR UROLOGIC SURGERY: AN ANALYSIS OF MORBIDITY AND MORTALITY USING A LARGE MULTI-CENTER RESEARCH NETWORK Tyler Garman, Andrew Gabrielson, Una Choi, Gabriella Ewachiw, and Andrew Cohen Tyler GarmanTyler Garman More articles by this author , Andrew GabrielsonAndrew Gabrielson More articles by this author , Una ChoiUna Choi More articles by this author , Gabriella EwachiwGabriella Ewachiw More articles by this author , and Andrew CohenAndrew Cohen More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003294.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Many studies evaluating complication rates following urologic procedures focus on a narrow subset of procedures, include the experience of select, high volume surgeons, or have variable follow-up. We systematically compare national complication rates following an array of urologic surgeries by numerous providers, which can serve as an important benchmarking tool in the pursuit of quality care. METHODS: We performed a retrospective cohort study using the TriNetX research network from 2006-2022, which includes claims data for 110 million patients. Procedure type, age at index procedure, sex, race, and complications were queried using applicable CPT and ICD10 codes. Rates of all-cause (Clavien I-V), life-threatening (Clavien IV), and mortality (Clavien V) complications were evaluated using 30-day, 90-day, and 1-year timepoints from the index operation. Clavien IV complications included: sepsis, acute renal failure requiring dialysis, PE, reintubation, myocardial infarction, cardiac arrest, and re-operation. RESULTS: A total of 484,099 urologic procedures were included. Age, sex, race, and 30-day, 90-day, and 1-year complication rates stratified by procedure are listed in Table 1. All-cause complication rates ranged from 2-37%, 10-48%, and 17-60% for 30-day, 90-day, and 1-year time points, respectively. Rates of Clavien IV complications were less than or equal to 10% at all timepoints for most procedures with notable exceptions being total nephrectomy (14-23%), cystectomy (22-36%), and RPLND (14-22%). The 1-year mortality rate for most procedures was low. Exceptions include cystectomy (12%), TURBT (8%), RPLND (6%), and total nephrectomy (5%). Procedures with the lowest rates of 30-day, 90-day, and 1-year complications included those within reconstructive urology including AUS placement, sling procedures for incontinence, colporrhaphy, IPP placement and urethroplasty. 30-day, 90-day, and 1-year mortality rates following these procedures mirrored that of the general population not undergoing surgery. CONCLUSIONS: This analysis establishes benchmark complication rates up to 1-year post-op for many urologic procedures using a national database, which can aid hospital systems in identifying deficiencies in quality care. Source of Funding: NA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e657 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tyler Garman More articles by this author Andrew Gabrielson More articles by this author Una Choi More articles by this author Gabriella Ewachiw More articles by this author Andrew Cohen More articles by this author Expand All Advertisement PDF downloadLoading ...
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