Key result
In 6,042 nephrectomies recorded in the UK in 2012, the overall 30-day mortality was 0.55%, and Clavien-Dindo grade ≥III complications occurred in 3.9% of cases.
Why the study?
What are the perioperative outcomes and safety of nephrectomies performed in the UK in 2012?
Observational (n=6,042)
Yes
What are the perioperative outcomes and safety of nephrectomies performed in the UK in 2012?
Nephrectomy in the UK in 2012 was a safe procedure with low morbidity and mortality rates, supporting the public reporting of surgeon-specific outcomes.
Affirms perioperative safety of nephrectomy in this UK cohort; leaves open impact of surgeon-specific reporting on current outcomes.
OBJECTIVE: To present the perioperative outcomes from the British Association of Urological Surgeons (BAUS) nephrectomy dataset for 2012, the first year of public reporting of individual surgeon outcomes in the UK. PATIENTS AND METHODS: All nephrectomies performed in the year 2012 and recorded in the database were analysed. These were divided into simple nephrectomy (SN), partial nephrectomy (PN), radical nephrectomy (RN), and nephroureterectomy (NU). The estimated capture rate for nephrectomy was 80%. The outcomes measured were 30-day mortality (30-DM), Clavien-Dindo complications grade ≥III, blood transfusion, conversion to open, and length of stay. RESULTS: The overall 30-DM was 0.55% (SN 0.53%; PN 0.10%; RN 0.52%; NU 1.27%). Clavien-Dindo complications grade ≥III were recorded in 3.9% of nephrectomies (SN 4.3%; PN 5.4%; RN 3.1%; NU 4.5%). Blood transfusion was required during surgical admission for 8.4% of nephrectomies (SN 5.2%; PN 3.4%; RN 11.1%; NU 8.3%). Conversion to open was carried out in 5.5% of minimally invasive nephrectomies (SN 6.1%; PN 4.0%; RN 5.5%; NU 5.6%). Open nephrectomy patients remained in hospital for a median of 6 days (SN 7; PN 5; RN 7; NU 8 days), which was higher than the median 4-day stay (SN 3; PN 4; RN 4; NU 5 days) for minimally invasive surgery. CONCLUSIONS: Nephrectomy in 2012 was a safe procedure with morbidity and mortality rates comparable with or less than published series. The collection of surgeon-specific data should be iterative with further refinement of data categories, support for the collection process and independent validation of results.
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Henderson et al. (2014) conducted an observational in Nephrectomy (n=6,042). Nephrectomy was evaluated on 30-day mortality. In 6,042 nephrectomies recorded in the UK in 2012, the overall 30-day mortality was 0.55%, and Clavien-Dindo grade ≥III complications occurred in 3.9% of cases.
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