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The association between patient body mass index and perioperative outcomes following radical cystectomy: An analysis using the American College of Surgeons National Surgical Quality Improvement Program database.

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Abstract:

INTRODUCTION:Radical cystectomy is a highly morbid procedure with 30-day perioperative complication rates approaching 50%. Our objective was to determine the effect of patients' body mass index (BMI) on perioperative outcomes following radical cystectomy for bladder cancer. METHODS:We identified 3930 eligible patients who underwent radical cystectomy for nonmetastatic bladder cancer using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. The primary exposure was preoperative BMI, categorically operationalized in four strata according to the World Health Organization criteria: <18.5 kg/m2, 18.5-25 kg/m2, and >30 kg/m2. Our primary outcome was major perioperative complication comprising mortality, reoperation, cardiac event, or neurological event. RESULTS:BMI was significantly associated with rates of major complications (p=0.003): major complications were experienced by 17.0% of patients with BMI <18.5 kg/m2, 7.8% of patients with BMI 18.5-25 kg/m2, 25-30 kg/m2, 7.9% of patients with BMI 25-30 kg/m2, and 10.8% of patient with BMI >30 kg/m2. Following multivariable adjustment for relevant demographic, comorbidity, and treatment factors, compared to patients with BMI 18.5-25 kg/m2, patients with BMI <18.5 kg/m2 (odds ratio [OR] 2.28; 95% confidence interval [CI] 1.07-4.78) and BMI >30 kg/m2 (OR 1.59; 95% CI 1.17-2.16) were significantly more likely to experience a major complication in the 30 days following cystectomy. Among the secondary outcomes, significant differences were identified in rates of pulmonary complications (p=0.003), infectious complications (p<0.001), bleeding requiring transfusion (p=0.01), and length of stay (p=0.001). CONCLUSIONS:Patients who are outside of a normal BMI range are more likely to experience major complications following radical cystectomy for bladder cancer.

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CUAJ-Canadian Urological Association Journal

CUAJ-CAN UROL ASSOC
最新影响因子:1.372 期刊ISSN:1911-6470 CiteScore:
出版周期:Bimonthly 是否OA:YES 出版年份:2007

期刊官方网址:http://www.cua.org/

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自引率:6.90% 研究方向:医学-泌尿学与肾脏学
出版地区:CANADA

SCI期刊coverage:Science Citation Index Expanded(科学引文索引扩展)

NCBI查询:PubMed Central (PMC)链接全文检索(pubmed central)

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CUAJ-Canadian Urological Association Journal 期刊简介

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CUAJ-Canadian Urological Association Journal 期刊中科院评价数据

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大类(学科) 小类(学科) 学科排名
医学 UROLOGY & NEPHROLOGY(泌尿学和肾脏学) 4区
64/76

最新公布的期刊年发文量

年度总发文量 年度论文发表量 年度综述发表量
162 120 42
总被引频次:1844
特征因子:0.004170

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