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The role of body mass index on quality indicators following minimally-invasive radical prostatectomy.
Pathak, Ram A; Wilson, Robert R A; Craven, Timothy E; Matz, Ethan; Hemal, Ashok K.
Afiliação
  • Pathak RA; Department of Urology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA. rpathak@wakehealth.edu.
  • Wilson RRA; Department of Urology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA.
  • Craven TE; Department of Urology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA.
  • Matz E; Department of Urology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA.
  • Hemal AK; Department of Urology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA.
Investig Clin Urol ; 62(3): 290-297, 2021 05.
Article em En | MEDLINE | ID: mdl-33834640
PURPOSE: We sought to determine the role of body mass index (BMI) on quality indicators, such as length of stay and readmission. The National Surgical Quality Improvement Program (NSQIP) database was queried to examine the effect of obesity, defined as BMI >30, on outcomes after Minimally Invasive Radical Retropubic Prostatectomy (MI-RRP). MATERIALS AND METHODS: Utilizing the NSQIP database, patient records were identified using the Current Procedural Terminology (CPT) code 55866 (laparoscopy, surgical prostatectomy, radical retropubic) during a 10-year period (2007-2017). Obesity was classified according to the CDC classification. Chi-square tests were utilized to evaluate BMI distribution by surgery year. Logistic regression was used to evaluate the relationship of BMI with length of stay (LOS) and hospital readmission within 30 days, after controlling for preoperative variables. RESULTS: Records of 49,238 patients who have undergone MI-RRP during 2007-2017 were evaluated. Mean yearly BMI rose from 28.5 to 29.2, while the percentage of surgical patients with BMI >30 rose by 5% (33% to 38%; p<0.0001) over the study period. Obese patients demonstrated higher morbidity, prolonged LOS, and increased readmission rates after MI-RRP. Obesity severity correlated negatively with quality indicators in a graded fashion. CONCLUSIONS: Obesity rates in patients undergoing MI-RRP increased from 2007-2017. Obese patients are at increased risk of morbidity, prolonged LOS, and readmission within 30 days, following MI-RRP. These patients should not be excluded from MI-RRP; rather, physicians should discuss these increased risks with their patients. Proper weight loss strategies should be instituted preoperatively to mitigate these risks.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Prostatectomia / Neoplasias da Próstata / Laparoscopia / Indicadores de Qualidade em Assistência à Saúde / Obesidade Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans / Male / Middle aged Idioma: En Revista: Investig Clin Urol Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Coréia do Sul

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Prostatectomia / Neoplasias da Próstata / Laparoscopia / Indicadores de Qualidade em Assistência à Saúde / Obesidade Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans / Male / Middle aged Idioma: En Revista: Investig Clin Urol Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Coréia do Sul