Patients who undergo a minimally invasive outpatient partial nephrectomy are at elevated risk for cardiac arrest and 30-day mortality compared with those who have the procedure performed in an inpatient setting, according to data presented at the Society of Urologic Oncology’s 23rd annual meeting in San Diego, California.
Using 2010 to 2020 data from the National Surgical Quality Improvement Program of the American College of Surgeons, investigators studied 28,227 patients who underwent a minimally invasive partial nephrectomy. Of these, 27,939 (98.9%) and 298 (1.1%) had inpatient and outpatient procedures, respectively. The groups did not differ significantly with respect to comorbidities.
The cardiac arrest rate was 1.3% among patients who underwent an outpatient partial nephrectomy compared with 0.2% among those who had an inpatient procedure, a significant difference between the groups, Spencer S. Liem, MD, of Mount Sinai Medical Center in Miami Beach, Florida, and colleagues reported. The rates of other complications did not differ significantly between the groups.
The inpatient group had a significantly longer operative time than the outpatient group (184.3 vs 165.1 minutes).
Although the outpatient partial nephrectomy group had a significantly higher 30-day mortality rate (1.3% vs 0.2%), their rates of reoperation (0.7% vs 1.7%) and readmission (3.4% vs 4.8%) did not differ significantly from the inpatient group, according to the investigators.
The proportion of minimally invasive partial nephrectomies performed on an outpatient basis increased during the study period from 0.40% in 2010 to 2.60% in 2020, the investigators reported.
Liem SS, Jivanji D, Demus T, et al. Safety and feasibility of outpatient partial nephrectomy in a national cohort. Presented at: SUO 2022, November 30 to December 2, San Diego, California. Poster 19.