Pereira JF, et al. - Authors performed this study to investigate the association of age with perioperative outcomes following radical prostatectomy (RP) to inform risk-stratification and management. Findings here revealed a nonlinear association of age with perioperative morbidity, with increasing rates of 30-day complications, perioperative blood transfusion, and readmission after approximately 70 years of age. Results appeared beneficial with respect to risk-stratification, patient counseling, and treatment selection among older men.

Methods

• From 2010 to 2015, researchers identified 35,968 men (aged 18 to 89 years) who underwent RP in the National Surgical Quality Improvement Program (NSQIP) database.
• An evaluation of the associations of age with 30-day complications and perioperative morbidity was performed using logistic regression, adjusted for patient features.
• They modeled age both as a categorical and nonlinear continuous variable.

Results

• At surgery, median age of patients was 63 years (IQR: 58–67).
• Greater rates of perioperative morbidity were observed with increasing age.
• Men aged 70 to 89 years indicated statistically significantly higher rates of 30-day complications (6.4% vs 4.4%, P < 0.0001), perioperative blood transfusion (6.0% vs. 3.7%, P < 0.0001), readmission (4.9% vs. 3.9%, P < 0001), and 30-day mortality (0.3% vs. 0.1%, P < 0.0001), compared to men aged<60 years.
• Multivariable analyses suggested that older age had an independent association with increased risks of perioperative morbidity.
• In addition, a nonlinear relationship of age with perioperative morbidity was identified, wherein rates of 30-day complications, perioperative blood transfusion, and readmission increased after approximately 70 years of age.