Characterization of perioperative infection risk among patients undergoing radical cystectomy: Results from the national surgical quality improvement program

Abstract Objectives To evaluate the incidence, risk factors, and timing of infections following radical cystectomy (RC). Methods The American College of Surgeons National Surgical Quality Improvement Project database was queried to identify patients undergoing RC for bladder cancer from 2006 to 2013...

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Published in:Urologic oncology 2016-12, Vol.34 (12), p.532.e13-532.e19
Main Authors: Parker, William P., M.D, Tollefson, Matthew K., M.D, Heins, Courtney N., B.S, Hanson, Kristine T., B.A, Habermann, Elizabeth B., Ph.D, Zaid, Harras B., M.D, Frank, Igor, M.D, Thompson, R. Houston, M.D, Boorjian, Stephen A., M.D., FACS
Format: Article
Language:English
Subjects:
Aged
Bladder cancer
Blood Transfusion
Carcinoma, Transitional Cell - epidemiology
Carcinoma, Transitional Cell - surgery
Comorbidity
Cystectomy
Datasets as Topic - statistics & numerical data
Diabetes Mellitus - epidemiology
Female
Humans
Infection
Infection - epidemiology
Male
Middle Aged
NSQIP
Obesity - epidemiology
Operative Time
Postoperative Complications - epidemiology
Quality Improvement - organization & administration
Radical cystectomy
Risk
Risk factors
Shock, Septic - epidemiology
Smoking - epidemiology
Surgical Wound Infection - epidemiology
Urinary Bladder Neoplasms - epidemiology
Urinary Bladder Neoplasms - surgery
Urinary diversion
Urinary Tract Infections - epidemiology
Urology
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Summary:Abstract Objectives To evaluate the incidence, risk factors, and timing of infections following radical cystectomy (RC). Methods The American College of Surgeons National Surgical Quality Improvement Project database was queried to identify patients undergoing RC for bladder cancer from 2006 to 2013. Characteristics including year of surgery, age, sex body mass index, diabetes, smoking, renal function, steroid usage, preoperative albumin, preoperative hematocrit, perioperative blood transfusion (PBT), and operative time were assessed for association with the risk of infection within 30 days of RC using multivariable logistic regression. Results A total of 3,187 patients who had undergone RC were identified, of whom 766 (24.0%) were diagnosed with a postoperative infection, at a median of 13 days (interquartile ranges 8-19) after RC. Infections included surgical site infection (SSI) (404; 12.7%), sepsis/septic shock (405; 12.7%), and urinary tract infection (UTI) (309; 9.7%). On multivariable analysis, body mass index≥30 kg/m2 (odds ratios [OR] = 1.52; P
ISSN:1078-1439
1873-2496
DOI:10.1016/j.urolonc.2016.07.001