Abstract
Introduction
The purpose of this study was to summarize the characteristics and identify associated
factors of postoperative pulmonary complications (PPCs) in patients undergoing radical
cystectomy (RC).
Materials and Methods
The National Surgical Quality Improvement Project (NSQIP) database (2005-2014) was
used to identify patients who underwent RC for bladder cancer. PPCs were defined as
pneumonia, unplanned reintubation, and ventilator support > 48 hours within 30 days
of RC. Incidence, timing, and outcomes of PPCs were described and analyzed. Multivariable
logistic regression was used to evaluate associated factors of PPCs.
Results
Among 3790 patients included, 213 (5.6%) had at least 1 PPC. Patients with PPCs had
a significantly higher 30-day mortality (17.4% vs. 0.7%; P < .001) and longer hospital stay (13 vs. 8 days; P < .001). Logistic regression showed that age ≥ 75 years (odds ratio [OR], 2.07; P = .001), body mass index < 18.5 kg/m2 (OR, 2.48; P = .017), body mass index ≥ 30 kg/m2 (OR, 1.71; P = .009), dependent functional status (OR, 2.77; P = .006), current smoker (OR, 1.57; P = .011), chronic obstructive pulmonary disease (OR, 1.70; P = .018), insulin-treated diabetes (OR, 1.70; P = .042), and albumin < 3.5 g/dL (OR, 1.72; P = .015) were associated with increased risk of overall PPCs.
Conclusion
Approximately 5.6% of patients have at least one PPC within 30 days of RC. Several
preoperative associated factors for PPCs were identified, which should be helpful
for risk stratification, patient counseling, and perioperative care.
Keywords
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Article info
Publication history
Published online: April 13, 2017
Accepted:
April 4,
2017
Received in revised form:
March 27,
2017
Received:
February 3,
2017
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
