Perioperative Complications and In-Hospital Mortality in Partial and Radical Nephrectomy Patients with Heart-Valve Replacement.
Comorbidities
Heart surgery
Heart-valve replacement
Kidney cancer
NIS
Journal
Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840
Informations de publication
Date de publication:
25 Mar 2024
25 Mar 2024
Historique:
received:
08
01
2024
accepted:
12
03
2024
medline:
25
3
2024
pubmed:
25
3
2024
entrez:
25
3
2024
Statut:
aheadofprint
Résumé
In-hospital mortality and complication rates after partial and radical nephrectomy in patients with history of heart-valve replacement are unknown. Relying on the National Inpatient Sample (2000-2019), kidney cancer patients undergoing partial or radical nephrectomy were stratified according to presence or absence of heart-valve replacement. Multivariable logistic and Poisson regression models addressed adverse hospital outcomes. Overall, 39,673 patients underwent partial nephrectomy versus 94,890 radical nephrectomy. Of those, 248 (0.6%) and 676 (0.7%) had a history of heart-valve replacement. Heart-valve replacement patients were older (median partial nephrectomy 69 versus 60 years; radical nephrectomy 71 versus 63 years), and more frequently exhibited Charlson comorbidity index ≥ 3 (partial nephrectomy 22 versus 12%; radical nephrectomy 32 versus 23%). In partial nephrectomy patients, history of heart-valve replacement increased the risk of cardiac complications [odds ratio (OR) 4.33; p < 0.001), blood transfusions (OR 2.00; p < 0.001), intraoperative complications (OR 1.53; p = 0.03), and longer hospital stay [rate ratio (RR) 1.25; p < 0.001], but not in-hospital mortality (p = 0.5). In radical nephrectomy patients, history of heart-valve replacement increased risk of postoperative bleeding (OR 4.13; p < 0.001), cardiac complications (OR 2.72; p < 0.001), intraoperative complications (OR 1.53; p < 0.001), blood transfusions (OR 1.27; p = 0.02), and longer hospital stay (RR 1.12; p < 0.001), but not in-hospital mortality (p = 0.5). History of heart-valve replacement independently predicted four of twelve adverse outcomes in partial nephrectomy and five of twelve adverse outcomes in radical nephrectomy patients including intraoperative and cardiac complications, blood transfusions, and longer hospital stay. Conversely, no statistically significant differences were observed in in-hospital mortality.
Sections du résumé
BACKGROUND
BACKGROUND
In-hospital mortality and complication rates after partial and radical nephrectomy in patients with history of heart-valve replacement are unknown.
PATIENTS AND METHODS
METHODS
Relying on the National Inpatient Sample (2000-2019), kidney cancer patients undergoing partial or radical nephrectomy were stratified according to presence or absence of heart-valve replacement. Multivariable logistic and Poisson regression models addressed adverse hospital outcomes.
RESULTS
RESULTS
Overall, 39,673 patients underwent partial nephrectomy versus 94,890 radical nephrectomy. Of those, 248 (0.6%) and 676 (0.7%) had a history of heart-valve replacement. Heart-valve replacement patients were older (median partial nephrectomy 69 versus 60 years; radical nephrectomy 71 versus 63 years), and more frequently exhibited Charlson comorbidity index ≥ 3 (partial nephrectomy 22 versus 12%; radical nephrectomy 32 versus 23%). In partial nephrectomy patients, history of heart-valve replacement increased the risk of cardiac complications [odds ratio (OR) 4.33; p < 0.001), blood transfusions (OR 2.00; p < 0.001), intraoperative complications (OR 1.53; p = 0.03), and longer hospital stay [rate ratio (RR) 1.25; p < 0.001], but not in-hospital mortality (p = 0.5). In radical nephrectomy patients, history of heart-valve replacement increased risk of postoperative bleeding (OR 4.13; p < 0.001), cardiac complications (OR 2.72; p < 0.001), intraoperative complications (OR 1.53; p < 0.001), blood transfusions (OR 1.27; p = 0.02), and longer hospital stay (RR 1.12; p < 0.001), but not in-hospital mortality (p = 0.5).
CONCLUSIONS
CONCLUSIONS
History of heart-valve replacement independently predicted four of twelve adverse outcomes in partial nephrectomy and five of twelve adverse outcomes in radical nephrectomy patients including intraoperative and cardiac complications, blood transfusions, and longer hospital stay. Conversely, no statistically significant differences were observed in in-hospital mortality.
Identifiants
pubmed: 38526833
doi: 10.1245/s10434-024-15228-6
pii: 10.1245/s10434-024-15228-6
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s).
Références
Motzer RJ, Jonasch E, Agarwal N, Alva A, Baine M, Beckermann K, et al. Kidney cancer, version 3.2022, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2022;20:71–90. https://doi.org/10.6004/jnccn.2022.0001 .
doi: 10.6004/jnccn.2022.0001
pubmed: 34991070
pmcid: 10191161
Ljungberg B, Albiges L, Abu-Ghanem Y, Bedke J, Capitanio U, Dabestani S, et al. European association of urology guidelines on renal cell carcinoma: the 2022 update. Eur Urol. 2022;82:399–410. https://doi.org/10.1016/j.eururo.2022.03.006 .
doi: 10.1016/j.eururo.2022.03.006
pubmed: 35346519
Agency for Healthcare Research and Quality, Rockville, MD. HCUP Nationwide Inpatient Sample (NIS). Healthcare Cost and Utilization Project (HCUP). 2008-2019 n.d. www.hcup-us.ahrq.gov/nisoverview.jsp (accessed September 2 2023).
Joudi FN, Veerasathpurush A, Kane CJ, Konety BR. Analysis of complications following partial and total nephrectomy for renal cancer in a population based sample. J Urol. 2007;177:1709–14. https://doi.org/10.1016/j.juro.2007.01.037 .
doi: 10.1016/j.juro.2007.01.037
pubmed: 17437791
Palumbo C, Knipper S, Dzyuba-Negrean C, Pecoraro A, Rosiello G, Tian Z, et al. Complication rates, failure to rescue and in-hospital mortality after cytoreductive nephrectomy in the older patients. J Geriatr Oncol. 2020;11:718–23. https://doi.org/10.1016/j.jgo.2019.06.005 .
doi: 10.1016/j.jgo.2019.06.005
pubmed: 31257163
Rosiello G, Re C, Larcher A, Fallara G, Sorce G, Baiamonte G, et al. The effect of frailty on post-operative outcomes and health care expenditures in patients treated with partial nephrectomy. Eur J Surg Oncol. 2022;48:1840–7. https://doi.org/10.1016/j.ejso.2022.01.001 .
doi: 10.1016/j.ejso.2022.01.001
pubmed: 35027234
Mazzone E, Nazzani S, Preisser F, Tian Z, Marchioni M, Bandini M, et al. Partial nephrectomy seems to confer a survival benefit relative to radical nephrectomy in metastatic renal cell carcinoma. Cancer Epidemiol. 2018;56:118–25. https://doi.org/10.1016/j.canep.2018.08.006 .
doi: 10.1016/j.canep.2018.08.006
pubmed: 30173050
Urja P, Walters RW, Vivekanandan R, Kumar M, Abdulghani S, Hari Belbase R, et al. Trends in the use of echocardiography in patients with Staphylococcus aureus bacteremia: an analysis using the Nationwide Inpatient Sample data. Echocardiography. 2019;36:1625–32. https://doi.org/10.1111/echo.14473 .
doi: 10.1111/echo.14473
pubmed: 31471983
Loh KP, Abdallah M, Shieh M-S, Stefan MS, Pekow PS, Lindenauer PK, et al. Use of inpatient palliative care services in patients with advanced cancer receiving critical care therapies. J Natl Compr Canc Netw. 2018;16:1055–64. https://doi.org/10.6004/jnccn.2018.7039 .
doi: 10.6004/jnccn.2018.7039
pubmed: 30181417
pmcid: 6553482
Mazzone E, Knipper S, Mistretta FA, Palumbo C, Tian Z, Gallina A, et al. Trends and social barriers for inpatient palliative care in patients with metastatic bladder cancer receiving critical care therapies. J Natl Compr Canc Netw. 2019;17:1344–52. https://doi.org/10.6004/jnccn.2019.7319 .
doi: 10.6004/jnccn.2019.7319
pubmed: 31693981
Mazzone E, Mistretta FA, Knipper S, Tian Z, Palumbo C, Gandaglia G, et al. Temporal trends and social barriers for inpatient palliative care delivery in metastatic prostate cancer patients receiving critical care therapies. Prostate Cancer Prostatic Dis. 2020;23:260–8. https://doi.org/10.1038/s41391-019-0183-9 .
doi: 10.1038/s41391-019-0183-9
pubmed: 31685982
United States Department of Labor, U.S. Bureau of labor statistics; consumer price index. n.d. https://www.bls.gov/cpi , 2021 (accessed December 6, 2023).
Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992;45:613–9. https://doi.org/10.1016/0895-4356(92)90133-8 .
doi: 10.1016/0895-4356(92)90133-8
pubmed: 1607900
Quan H, Sundararajan V, Halfon P, Fong A, Burnand B, Luthi J-C, et al. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Medical Care. 2005;43:1130–9.
doi: 10.1097/01.mlr.0000182534.19832.83
pubmed: 16224307
R Core Team. R: A Language and Environment for Statistical Computing. R: A Language and Environment for Statistical Computing 2022. https://www.R-project.org/ (accessed August 27, 2023).
Bianchi M, Gandaglia G, Trinh Q-D, Hansen J, Becker A, Abdollah F, et al. A population-based competing-risks analysis of survival after nephrectomy for renal cell carcinoma. Urol Oncol. 2014;32:46.e1-46.e7. https://doi.org/10.1016/j.urolonc.2013.06.010 .
doi: 10.1016/j.urolonc.2013.06.010
pubmed: 24054864
Cano Garcia C, Flammia RS, Piccinelli M, Panunzio A, Tappero S, Barletta F, et al. Differences in survival of clear cell metastatic renal cell carcinoma according to partial versus radical cytoreductive nephrectomy. Clin Genitourin Cancer. 2023. https://doi.org/10.1016/j.clgc.2023.06.003 .
doi: 10.1016/j.clgc.2023.06.003
pubmed: 37690970
Baudo A, Incesu R-B, Morra S, Scheipner L, Jannello LMI, de Angelis M, et al. Other-cause mortality, according to partial versus radical nephrectomy: age and stage analyses. Clin Genitourin Cancer. 2024;22:181–8. https://doi.org/10.1016/j.clgc.2023.10.011 .
doi: 10.1016/j.clgc.2023.10.011
pubmed: 38042729