World J Urol DOI 10.1007/s00345-015-1564-x
ORIGINAL ARTICLE
An evaluation of the timing of surgical complications following nephrectomy: data from the American College of Surgeons National Surgical Quality Improvement Program (ACS‑NSQIP) Akshay Sood1,2 · Firas Abdollah1 · Jesse D. Sammon1,2 · Victor Kapoor1 · Craig G. Rogers1 · Wooju Jeong1 · Dane E. Klett1 · Julian Hanske2 · Christian P. Meyer2 · James O. Peabody1 · Mani Menon1 · Quoc‑Dien Trinh2 Received: 9 January 2015 / Accepted: 14 April 2015 © Springer-Verlag Berlin Heidelberg 2015
Abstract Purpose The rates of complications following radical/ partial nephrectomy (RN/PN) are well known; however, the data regarding timing are opaque. Accordingly, we sought to assess the median time-to-event for 19 principal postoperative complications within 30 days following surgery. Methods Patients undergoing RN/PN were identified within the American College of Surgeons National Surgical Quality Improvement Program database (2005–2011). Primary endpoint was time-to-complication. Secondary endpoints included length-of-stay (LOS), re-intervention, re-admission and 30-day mortality. Multivariable regression models assessed the predictors for pre-/post-discharge complications and the effect of time-to-complication on secondary outcomes. Results Overall, 3820 patients underwent nephrectomy (RN = 63.6 %). The overall complication rate was 16.8 %, and the median LOS was 4 days. The majority of major complications (88.1 %), including bleeding/ transfusion, renal, septic, deep venous thrombosis or pulmonary embolism, pulmonary, cardiac and neurologic, occurred prior to discharge. Conversely, the relatively
Electronic supplementary material The online version of this article (doi:10.1007/s00345-015-1564-x) contains supplementary material, which is available to authorized users. * Akshay Sood [email protected]; [email protected] 1
Center for Outcomes Research, Analytics and Evaluation (VCORE), Vattikuti Urology Institute, Henry Ford Health System, 2799 W. Grand Boulevard, Detroit, MI 48202, USA
2
Division of Urologic Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
minor complications, including wound and urinary tract infections, occurred predominantly post-discharge (70.7 %). The median time to major complications was 3 versus 13 days for minor complications. In multivariable analyses, age [odds ratio (OR) 1.02, p
ORIGINAL ARTICLE
An evaluation of the timing of surgical complications following nephrectomy: data from the American College of Surgeons National Surgical Quality Improvement Program (ACS‑NSQIP) Akshay Sood1,2 · Firas Abdollah1 · Jesse D. Sammon1,2 · Victor Kapoor1 · Craig G. Rogers1 · Wooju Jeong1 · Dane E. Klett1 · Julian Hanske2 · Christian P. Meyer2 · James O. Peabody1 · Mani Menon1 · Quoc‑Dien Trinh2 Received: 9 January 2015 / Accepted: 14 April 2015 © Springer-Verlag Berlin Heidelberg 2015
Abstract Purpose The rates of complications following radical/ partial nephrectomy (RN/PN) are well known; however, the data regarding timing are opaque. Accordingly, we sought to assess the median time-to-event for 19 principal postoperative complications within 30 days following surgery. Methods Patients undergoing RN/PN were identified within the American College of Surgeons National Surgical Quality Improvement Program database (2005–2011). Primary endpoint was time-to-complication. Secondary endpoints included length-of-stay (LOS), re-intervention, re-admission and 30-day mortality. Multivariable regression models assessed the predictors for pre-/post-discharge complications and the effect of time-to-complication on secondary outcomes. Results Overall, 3820 patients underwent nephrectomy (RN = 63.6 %). The overall complication rate was 16.8 %, and the median LOS was 4 days. The majority of major complications (88.1 %), including bleeding/ transfusion, renal, septic, deep venous thrombosis or pulmonary embolism, pulmonary, cardiac and neurologic, occurred prior to discharge. Conversely, the relatively
Electronic supplementary material The online version of this article (doi:10.1007/s00345-015-1564-x) contains supplementary material, which is available to authorized users. * Akshay Sood [email protected]; [email protected] 1
Center for Outcomes Research, Analytics and Evaluation (VCORE), Vattikuti Urology Institute, Henry Ford Health System, 2799 W. Grand Boulevard, Detroit, MI 48202, USA
2
Division of Urologic Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
minor complications, including wound and urinary tract infections, occurred predominantly post-discharge (70.7 %). The median time to major complications was 3 versus 13 days for minor complications. In multivariable analyses, age [odds ratio (OR) 1.02, p
