Perioperative outcomes between primary and replacement artificial urinary sphincter surgery: An ACS-NSQIP analysis.
| Autor: | Jella, Tarun, Fernstrum, Austin, Callegari, Michael, Cwalina, Tom, Mundey, Wade, Mahran, Amr, Petrinic, Benjamin, Ray, Al, Elghalban, Heba, Abdelrazek, Mostafa, Loeb, Aram, Thirumavalavan, Nannan, Gupta, Shubham |
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| Předmět: |
PERIOPERATIVE care
CARDIOVASCULAR diseases risk factors LENGTH of stay in hospitals MEN'S health UROLOGICAL prostheses AGE distribution LUNG diseases SURGERY PATIENTS FISHER exact test RETROSPECTIVE studies TREATMENT duration DIABETES PATIENT readmissions ARTIFICIAL sphincters TREATMENT effectiveness RISK assessment T-test (Statistics) COMPARATIVE studies SURGICAL site infections URINARY incontinence QUALITY assurance POSTOPERATIVE period REOPERATION DESCRIPTIVE statistics LOGISTIC regression analysis BODY mass index DISEASE risk factors EVALUATION |
| Zdroj: | Turkish Journal of Urology; Sep2021, Vol. 47 Issue 5, p427-435, 9p |
| Abstrakt: | Objective: To evaluate differences in perioperative clinical outcomes in men undergoing artificial urinary sphincter (AUS) implantation in primary versus replacement settings. Secondarily, we aimed to identify patient-related factors contributing to complications associated with AUS placement. Materials and Methods: A review of the American College of Surgeons-National Surgical Quality Improvement Program was performed between 2010 and 2018 identifying males undergoing AUS implantation. Subjects were further subdivided into primary implantation or removal/replacement of AUS simultaneously via current procedural terminology codes 53445 and 53447, respectively. 30-Day postoperative outcomes were compared between cohorts using t-test and Fisher's exact test. The relationship between patient factors and complications was evaluated using logistic regression. Results: A total of 1,892 patients were identified: 1,445 primary AUS placement and 447 AUS replacement procedures. Patients undergoing AUS replacement were statistically older than those undergoing primary implantation (71.4 vs 69.7 years, P < .001). AUS replacement procedures were associated with an increased rate of superficial surgical site infection (SSI) compared to primary procedures (1.3% vs 0.4%, P = .042). There were no differences identified between cohorts for deep SSI, cardiopulmonary complications, reoperation, operative time, or length of stay. Logistic regression demonstrated that higher body mass index was found to be independent risk factors for any complications, and diabetes mellitus was associated with increased risk of AUS-related readmission. Conclusion: Within the perioperative period, patients undergoing replacement AUS have an increased risk of superficial SSI compared to primary AUS implantation. These findings can assist with appropriate perioperative counseling of patients undergoing primary and replacement AUS implantations. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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