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• W2155159660 abstract "No AccessJournal of UrologyAdult Urology1 Sep 2011The Effect of Age on the Morbidity of Kidney Surgery Robert Abouassaly, Shabbir M.H. Alibhai, George A. Tomlinson, David R. Urbach, and Antonio Finelli Robert AbouassalyRobert Abouassaly Urological Institute, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio More articles by this author , Shabbir M.H. AlibhaiShabbir M.H. Alibhai Division of General Internal Medicine, University of Toronto, Toronto, Ontario, Canada Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada More articles by this author , George A. TomlinsonGeorge A. Tomlinson Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada More articles by this author , David R. UrbachDavid R. Urbach Department of Surgical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada More articles by this author , and Antonio FinelliAntonio Finelli Department of Surgical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.04.077AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Previous reports of the morbidity of renal surgery have been primarily from academic tertiary referral centers and, thus, they may not reflect general clinical practice. We determined the effect of age and comorbidity on in-hospital surgical morbidity for radical and partial nephrectomy on a population level. Materials and Methods: Data were obtained from a Canadian national discharge abstract database. From April 1998 to March 2008 information was available on 20,286 radical and 4,292 partial nephrectomies. Complications were identified using specific ICD-9 and 10 diagnosis and procedure codes. Complication rates were estimated by procedure type and by various explanatory variables, including patient age and Charlson comorbidity score. Multivariate logistic regressions were constructed for radical and partial nephrectomy to determine associations between explanatory variables and complications. Results: Overall complications developed in 34.1% of radical and 34.3% of partial nephrectomy cases. Patients were more likely to have cardiac, respiratory, vascular and surgical complications after radical nephrectomy while they were more likely to experience genitourinary and nephrectomy specific complications after partial nephrectomy. On multivariate logistic regression after radical and partial nephrectomy complications increased with age and Charlson score. After adjusting for other covariates patients with a Charlson score of greater than 2 were approximately 6 times more likely to experience a complication than patients with a Charlson score of 0 for radical and partial nephrectomy (OR 6.22, 95% CI 5.18–7.48 and OR 5.68, 95% CI 3.72–8.66, respectively). Conclusions: In our population based study radical nephrectomy and partial nephrectomy were associated with higher morbidity than previously reported, particularly in the elderly population and in patients with comorbidity. References 1 : Rising incidence of small renal masses: a need to reassess treatment effect. J Natl Cancer Inst2006; 98: 1331. Google Scholar 2 : Complications of nephron sparing surgery for renal tumors. J Urol1994; 151: 1177. Link, Google Scholar 3 : Complications of radical and partial nephrectomy in a large contemporary cohort. 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Google Scholar 30 : Defining early morbidity of radical cystectomy for patients with bladder cancer using a standardized reporting methodology. Eur Urol2009; 55: 164. Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byLaguna M (2020) Re: Comparing Outcomes for Patients with Clinical T1b Renal Cell Carcinoma Treated with either Percutaneous Microwave Ablation or SurgeryJournal of Urology, VOL. 203, NO. 6, (1058-1059), Online publication date: 1-Jun-2020. Volume 186Issue 3September 2011Page: 811-816 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordsnephrectomymorbiditycarcinoma, renal cellkidneypostoperative complicationsMetricsAuthor Information Robert Abouassaly Urological Institute, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio More articles by this author Shabbir M.H. Alibhai Division of General Internal Medicine, University of Toronto, Toronto, Ontario, Canada Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada More articles by this author George A. Tomlinson Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada More articles by this author David R. Urbach Department of Surgical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada More articles by this author Antonio Finelli Department of Surgical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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