Analysis of complications following partial and total nephrectomy for renal cancer in a population based sample

被引:73
作者
Joudi, Fadi N.
Allareddy, Veerasathpurush
Kane, Christopher J.
Konety, Badrinath R.
机构
[1] Univ Calif San Francisco, Mt Zion Med Ctr, Dept Urol, San Francisco, CA 94143 USA
[2] Univ Iowa, Dept Urol, Iowa City, IA 52242 USA
关键词
nephrectomy; postoperative complications; hospital mortality; length of stay; hospital charges;
D O I
10.1016/j.juro.2007.01.037
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: We determined the frequency and predictors of complications of partial and total nephrectomy in a population based sample. Materials and Methods: There were 3,019 partial and 18,575 total nephrectomies identified from the Nationwide Inpatient Sample data set of the Healthcare Cost and Utilization Project (2000 to 2003). The prevalence of International Classification of Diseases, 9th Revision coded complications following nephrectomy was determined. Hospital and patient related factors associated with the occurrence of a complication were determined by logistic regression analysis. We evaluated the impact of complications on in-hospital mortality, length of stay and hospital charges. Results: Respiratory, digestive and bleeding complications were the most common, with similar patterns for partial nephrectomy and total nephrectomy. Significant predictors of complications after total nephrectomy included age, male sex, comorbidity severity index and hospital location (rural vs urban), while comorbidity was the only significant predictor for partial nephrectomy complications. Any complication had a significant impact on in-hospital mortality, total charges and length of stay. Digestive and urinary complications, hemorrhage, and postoperative infections had a significant impact on in-hospital mortality after partial nephrectomy, while these same complications, in addition to respiratory and cardiac complications, had a significant impact on total charges and length of stay. All except digestive complications had a significant impact on mortality, hospital charges and length of stay for patients undergoing total nephrectomy. Conclusions: In a population based cohort partial nephrectomy and total nephrectomy are associated with low morbidity and mortality profiles, and all complications affect mortality, length of hospital stay and charges.
引用
收藏
页码:1709 / 1714
页数:6
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