Alcohol Use Disorder versus Adverse In-Hospital Outcomes after Radical Cystectomy and Ileal Conduit Urinary Diversion

Radical cystectomy (RC) is the gold standard treatment for muscle-invasive bladder cancer (BCa). Alcohol use disorder (AUD) may predispose to worse adverse in-hospital outcomes after RC and ileal conduit urinary diversion. The current study addressed this knowledge gap. Descriptive analyses, propensity score matching (PSM), and multivariable logistic and Poisson regression models were used to address patients with BCa treated with RC and ileal conduit within National Inpatient Sample (2006–2019). Of 15,018 RC and ileal conduit patients, 320 (2.1%) had history of AUD at baseline. Compared with their non-AUD counterparts, patients with AUD exhibited significantly higher rates of adverse in-hospital outcomes in 9 of 14 categories, namely: critical care therapies (Δ + 12.0%), overall complications (Δ + 11.0%), prolonged length of stay (Δ + 11.0%), pulmonary complications (Δ + 6.0%), acute kidney injury (Δ + 5.0%), hepatic complications (Δ + 3.2%), in-hospital mortality (Δ + 2.8%), cardiac complications (Δ + 1.6%), and total hospital charges (Δ + 7925 US$, all p < 0.05). After multivariable adjustment, AUD independently predicted higher rates of adverse in-hospital outcomes in the same 9 of 15 categories, namely: hepatic complications [odds ratio (OR) 3.3], in-hospital mortality (OR 3.2), acute kidney injury (OR 1.7), overall complications (OR 1.7), cardiac complications (OR 1.5), critical care therapies (OR 1.4), prolonged length of stay (OR 1.3), pulmonary complications (OR 1.2), and total hospital charges (OR 1.2, all p < 0.01). Since AUD significantly predisposes to higher rates of adverse in-hospital outcomes and in-hospital mortality after RC and ileal conduit urinary diversion, precautionary measures prior to admission and during hospital stay may be warranted in patients with AUD.