Mp77-15 Effect of Metabolic Syndrome on Perioperative Outcomes After Radical Cystectomy: A National Surgical Quality Improvement Program Analysis

You have accessJournal of UrologyBladder Cancer: Invasive VI (MP77)1 May 2024MP77-15 EFFECT OF METABOLIC SYNDROME ON PERIOPERATIVE OUTCOMES AFTER RADICAL CYSTECTOMY: A NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM ANALYSIS Aaron S. Dahmen, David J. Nusbaum, Alon Lazarovich, Jared Fialkoff, Parth K. Modi, and Piyush K. Agarwal Aaron S. DahmenAaron S. Dahmen , David J. NusbaumDavid J. Nusbaum , Alon LazarovichAlon Lazarovich , Jared FialkoffJared Fialkoff , Parth K. ModiParth K. Modi , and Piyush K. AgarwalPiyush K. Agarwal View All Author Informationhttps://doi.org/10.1097/01.JU.0001009404.49693.12.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical cystectomy (RC) is a highly morbid procedure with short term perioperative complications rates cited to be as high as 50%. Short term perioperative complications have previously been demonstrated to be more frequent in underweight and overweight patients. While abnormal body mass index has been demonstrated to have worsened perioperative outcomes, we sought to evaluate the impact metabolic syndrome has on outcomes. METHODS: We identified 4,694 eligible patients who underwent RC for non-metastatic bladder cancer using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database between the years of 2019-2021. The primary exposure was the presence of metabolic syndrome (BMI >30, hypertension, diabetes) and included 388 patients. Our primary outcome was major perioperative complications with secondary outcomes of length of stay, return to operating room, and operative time. RESULTS: The data was extracted and analyzed within a multivariable logistic regression adjusting for age, sex, surgical approach and operative time. The presence of metabolic syndrome increased the rate of readmission (OR 1.730, CI 1.365-2.179, p<0.001), pulmonary embolism (OR 2.151, CI 0.975-4.241, p=0.039), renal failure (OR 2.261, 1.071-4.314, p=0.020), urinary tract infection (OR 1.470, CI 1.001-2.097, p=0.041), sepsis (OR 2.061, CI 1.477-2.823, p<0.001), and superficial surgical site infection (OR 1.607, CI 1.041-2.397, p<0.001). CONCLUSIONS: Metabolic syndrome appears to demonstrate worse perioperative outcomes following radical cystectomy. The rate is higher than the impact of increasing body mass index alone. We did not identify any compounded affect with subanalysis of surgical approach (either open or minimally invasive). Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1258 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Aaron S. Dahmen More articles by this author David J. Nusbaum More articles by this author Alon Lazarovich More articles by this author Jared Fialkoff More articles by this author Parth K. Modi More articles by this author Piyush K. Agarwal More articles by this author Expand All Advertisement PDF downloadLoading ...