You have accessJournal of UrologyProstate Cancer: Localized1 Apr 2011479 OPEN RADICAL PROSTATECTOMY IN THE ELDERLY: A CASE FOR CONCERN? Jan Schmitges, Firas Abdollah, Maxine Sun, Claudio Jeldres, Lars Budäus, Hendrik Isbarn, Daniel Liberman, Orchidee Djahangirian, Paul Perrotte, Felix K. Chun, Francesco Montorsi, Alexander Haese, Markus Graefen, and Pierre I. Karakiewicz Jan SchmitgesJan Schmitges Hamburg, Germany More articles by this author , Firas AbdollahFiras Abdollah Milan, Italy More articles by this author , Maxine SunMaxine Sun Montreal, Canada More articles by this author , Claudio JeldresClaudio Jeldres Montreal, Canada More articles by this author , Lars BudäusLars Budäus Hamburg, Germany More articles by this author , Hendrik IsbarnHendrik Isbarn Hamburg, Germany More articles by this author , Daniel LibermanDaniel Liberman Montreal, Canada More articles by this author , Orchidee DjahangirianOrchidee Djahangirian Montreal, Canada More articles by this author , Paul PerrottePaul Perrotte Montreal, Canada More articles by this author , Felix K. ChunFelix K. Chun Hamburg, Germany More articles by this author , Francesco MontorsiFrancesco Montorsi Milan, Italy More articles by this author , Alexander HaeseAlexander Haese Hamburg, Germany More articles by this author , Markus GraefenMarkus Graefen Hamburg, Germany More articles by this author , and Pierre I. KarakiewiczPierre I. Karakiewicz Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.573AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Open radical prostatectomy (ORP) in individuals aged 75 years or older may be associated with a limited survival benefit. We tested the hypothesis that ORPs in elderly patients are predominantly performed at low volume and/or at non-academic institutions. METHODS Within the Health Care Utilization Project Nationwide Inpatient Sample (NIS) we focused on patients in whom ORP was performed within the 10 most contemporary years (1998–2007). Subsequently, we restricted the analysis to those patients aged 75 years or older. In those individuals, we examined the rate of ORP in elderly patients according to intraoperative and in-hospital complication rates. Subsequently, we stratified the rates according to annual hospital volume (AHV) tertiles and institutions type. Multivariable logistic regression analyses further adjusted for race and baseline Charlson Comorbidity Index (CCI). RESULTS Overall, 115623 patients undergoing ORP were identified, among those 2110 individuals were aged 75 years or older (1.8%). The annual ORP rate ranged from 2.6 to 2.0% (P=0.9). The vast majority of elderly patients treated with ORP were operated at low (36.4%) and intermediate (35.9%) volume institutions. The intraoperative complications were higher at low (2.7%) and intermediate (2.5%) volume hospitals than at high volume centers (1.9%, p=0.6). Similarly, the rates of in-hospital complications were also higher at low (19.2%) and intermediate (17.0%) volume hospitals, than at high volume centers (13.3%, p=0.02). Moreover, 56.2% of elderly patients treated with ORP were operated at non-academic institutions. Intraoperative complications were 2.7 vs. 2.1% (p=0.3) and in hospital complications were 19.1 vs. 13.9% (p=0.002) at non-academic vs. academic institutions, respectively. CONCLUSIONS It is worrisome that the vast majority of elderly patients is treated at low or intermediate volume (72.3%) and/or non-academic (56.2%) hospitals. This finding is even more worrisome, since the complication rates at low and intermediate volume institutions are higher. More favourable in-hospital complication rates were also recorded for teaching institutions than for non-teaching centers. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e195 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jan Schmitges Hamburg, Germany More articles by this author Firas Abdollah Milan, Italy More articles by this author Maxine Sun Montreal, Canada More articles by this author Claudio Jeldres Montreal, Canada More articles by this author Lars Budäus Hamburg, Germany More articles by this author Hendrik Isbarn Hamburg, Germany More articles by this author Daniel Liberman Montreal, Canada More articles by this author Orchidee Djahangirian Montreal, Canada More articles by this author Paul Perrotte Montreal, Canada More articles by this author Felix K. Chun Hamburg, Germany More articles by this author Francesco Montorsi Milan, Italy More articles by this author Alexander Haese Hamburg, Germany More articles by this author Markus Graefen Hamburg, Germany More articles by this author Pierre I. Karakiewicz Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...