Risk Factors for Reoperation After Radical Cystectomy Identified

Increasing body mass index and a history of chronic obstructive pulmonary disease (COPD) are associated with high reoperation rates within 30 days of radical cystectomy (RC), according to study findings presented at the 20^th annual meeting of the Society of Urologic Oncology in Washington, DC.

The results will help physicians identify patients at higher risk of adverse events prior to RC and allow them to adopt more aggressive approaches to minimize postoperative surgical complications, a team led by Zachary Klaassen MD, of the Medical College of Georgia in Augusta, and colleagues concluded in a poster presentation.

Using the American College of Surgeons National Surgical Quality Improvement Program database, Dr Klaassen and his colleagues identified 2608 patients (median age 69 years) who underwent RC for non-metastatic muscle-invasive bladder cancer (MIBC). Of these, 152 (5.8%) had a reoperation within 30 days of their RC. The body mass index (BMI) of patients who had a reoperation within 30 days of RC was significantly higher than for those who did not (29.1 vs 27.8 kg/m²). The proportion of patients who had a reoperation in this timeframe was significantly higher for those with a history of COPD than for those no COPD history (12.3% vs 5.3%). In addition, black patients had a significantly higher rate of reoperation within 30 days compared with white patients and those of other races (10.9% vs 5.1% and 4.0%, respectively).

On multivariate analysis, each 1 kg/m² increment in body mass index was significantly associated with 4% increased odds of reoperation within 30 days. A history of COPD was significantly associated with 2.2-fold increased odds of reoperation compared with no history of COPD. In addition, compared with white race, black race was significantly associated with nearly 2.3-fold increased odds of reoperation.

Further, patients who had a reoperation within 30 days of RC were more likely to die and experience cardiac, pulmonary, neurologic, and venous thromboembolic events than those not reoperated on within 30 days of RC. They also had a longer hospital length of stay and infectious complications.

Reference

Sayyid R, Magee D, Hird A, et al. Reoperation within 30 days of radical cystectomy: Identifying high-risk patients using the American College of Surgeons National Surgical Quality Improvement Program Database. Presented at the Society of Urologic Oncology 20th Annual Meeting held December 4 to 5 in Washington, DC. Poster 11.