Age-stratified perioperative mortality after urological surgeries

  • Brendan Wallace University of Ottawa
  • Rodney H. Breau University of Ottawa
  • Sonya Cnossen University of Ottawa
  • Christopher Knee University of Ottawa
  • Daniel McIsaac University of Ottawa
  • Ranjeeta Mallick The Ottawa Hospital Research Institute
  • Ilias Cagiannos University of Ottawa
  • Christopher Morash University of Ottawa
  • Luke T. Lavallee University of Ottawa

Abstract

Introduction: More elderly patients are presenting for surgical consultation. Understanding the risk of mortality by age group after urological surgery is important for patient selection and counselling.

Methods: A historical cohort study of The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database from 2006–2015 was performed. Current procedural terminology (CPT) codes for similar surgical procedures were grouped for analyses. Urological procedures commonly performed in elderly patients were identified and stratified by patient age and surgical approach (open vs. laparoscopic/robotic). The primary outcome was the absolute risk of death by 30 days stratified by age for each surgical procedure. The secondary outcome was risk of death by surgical approach (open vs. laparoscopic/robotic).

Results: Twelve urological procedures were reviewed including 124 262 patients. A total of 1011 (0.8%) deaths occurred by 30 days after surgery. The procedure with the highest incidence of mortality by 30 days was open nephroureterectomy (2.9 %). In patients 80 years and over, the procedure with the highest incidence of death was open radical nephrectomy (5.32%). There was an increased risk of mortality with increasing age group for all procedures. Unadjusted risk of mortality was consistently higher in patients who receive open compared to laparoscopic surgery.

Conclusions: There is an increasing risk of mortality with age and with open surgical approach in urology. Knowledge regarding the absolute risk of mortality in patients receiving common urological surgeries may improve patient selection and counselling.

Author Biographies

Brendan Wallace, University of Ottawa
3rd year urology resident at the University of Ottawa
Luke T. Lavallee, University of Ottawa

Associate Scientist, Ottawa Hospital Research Institute

Division of Urology, The University of Ottawa, General Campus

501 Smyth Rd. Box 222

Ottawa, ON K1H 8L6

Phone: 613-737-8899 ext. 73019

Email: lulavallee@toh.ca
Published
2018-03-26
How to Cite
Wallace, B., Breau, R. H., Cnossen, S., Knee, C., McIsaac, D., Mallick, R., Cagiannos, I., Morash, C., & Lavallee, L. T. (2018). Age-stratified perioperative mortality after urological surgeries. Canadian Urological Association Journal, 12(8). https://doi.org/10.5489/cuaj.5022
Section
Original Research