Does gender influence morbidity or mortality in the surgical treatment of renal masses?

Authors

  • Brian J. Minnillo Urological Institute, University Hospitals Case Medical Center, Case Western Reserve University
  • Andrew Horowitz Urological Institute, University Hospitals Case Medical Center, Case Western Reserve University
  • Antonio Finelli Department of Surgical Oncology, Princess Margaret Hospital, University of Toronto
  • Shabbir Alibhai Department of Medicine, University of Toronto
  • Lee E. Ponsky Urological Institute, University Hospitals Case Medical Center, Case Western Reserve University
  • Robert Abouassaly Urological Institute, University Hospitals Case Medical Center, Case Western Reserve University

DOI:

https://doi.org/10.5489/cuaj.1674

Keywords:

gender, nephrectomy, postoperative complications, hospital mortality

Abstract

Introduction: We determine the relationship between gender and surgical morbidity after radical nephrectomy (RN) and partial nephrectomy (PN) for renal masses on a population level.

Methods: We conducted a population-based, retrospective study using the Canadian Institute for Health Information Discharge Abstract Database. This included 20 286 RNs (82.5%) and 4292 PNs (17.5%) from April 1, 1998 to March 31, 2008. Complications were identified by ICD-9 and 10 codes, and comorbidity was assessed with the Charlson Index. The association between gender and in-hospital complication rates and mortality were examined using the Chi-square test, as well as with multivariable logistic regression, adjusting for explanatory variables including type of surgery, age, and comorbidity.

Results: Overall, men experienced a higher unadjusted complication rate than women (35.1% vs. 32.7%), as well as a higher unadjusted in-hospital mortality rate (1.46% vs. 0.84%), respectively. Men also demonstrated significantly higher rates of cardiac, wound, nephrectomy-specific, and medical complications. Women experienced fewer complications than men after RN (p = 0.0002), but not after PN (p = 0.33). On multivariable logistic regression analysis, women had a lower overall complication rate (odds ratio [OR] 0.94, 95% confidence interval [CI] 0.88-0.99), and a lower in-hospital mortality rate (OR 0.64, 95% CI 0.49-0.83) after kidney surgery.

Conclusions: In our population-based analysis, in-hospital morbidity after renal surgery was significantly lower for women. Further study is needed to determine if the observed effect is related to differences in surgical difficulty, perioperative care, or unmeasured confounders.

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Published

2014-05-21

How to Cite

Minnillo, B. J., Horowitz, A., Finelli, A., Alibhai, S., Ponsky, L. E., & Abouassaly, R. (2014). Does gender influence morbidity or mortality in the surgical treatment of renal masses?. Canadian Urological Association Journal, 8(5-6), e311–6. https://doi.org/10.5489/cuaj.1674

Issue

Section

Original Research