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Temporal trends in perioperative morbidity for radical cystectomy using the national surgical quality improvement program database

Urologic Oncology: Seminars and Original Investigations Aug 16, 2017

Johnson SC, et al. – Aim of this research was to assess recent temporal trends in postoperative complication rates following radical cystectomy (RC) applying a large national dataset. It was showed that RC remains a procedure correlated with high morbidity. In the recent era of enhanced recovery protocols, complication rates have not changed significantly, nevertheless, there has been a consistent decline in length of stay and use of blood transfusion.

Methods
  • Researchers distinguished patients undergoing RC applying recent procedural terminology codes using the National Surgical Quality Improvement Program participant use files from 2010 to 2015.
  • They compared demographic information as well as 30-day complications, length of stay (LOS), readmission and death according to year of operation using univariable and multivariable analysis.

Results
  • Researchers distinguished 6,510 patients for analysis over the 6 year period analyzed.
  • In this analysis, age and comorbidity were similar across the study period.
  • They applied a robotic technique in 5.8% of the entire cohort which did not differ among years.
  • A total of 15.9% of patients underwent a continent urinary diversion, with a trend toward decreased use in recent years, 31.5% of patients experienced a complication and this did not differ significantly among years, and 40.7% of patients required a blood transfusion overall with a trend toward decreased use.
  • The data suggested that LOS decreased over time from 10.6 days in 2010 to 9.2 days in 2015 (P<0.01) whereas readmissions increased slightly over the time period to 21.4% in 2015 (P<0.01).
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