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Obese patients undergoing cystectomy: A population‐based, propensity score matched analysis
Author(s) -
Tyson Mark D,
Humphreys Mitchell R,
Castle Erik P
Publication year - 2014
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12340
Subject(s) - medicine , propensity score matching , body mass index , perioperative , cystectomy , obesity , population , surgery , bladder cancer , environmental health , cancer
Objective To examine the impact of body mass index, as a measure of obesity, on the surgical outcomes of cystectomy. Methods The A merican College of Surgeons National Surgical Quality Improvement Program database was used to acquire data on 1293 cystectomies carried out from 2005 to 2011. Patients were divided into two groups: body mass index <30 kg/m 2 and ≥30 kg/m 2 . A propensity score‐matched analysis of perioperative outcomes was carried out. Results A total of 869 patients had a body mass index <30, whereas 424 had a body mass index ≥30. Unadjusted comparisons showed higher rates of superficial surgical site infections (8.7% vs 5.3%, P = 0.04), renal insufficiency (4.0% vs 1.7%, P = 0.01) and increased operative times (365.7 min vs 338.6 min, P = 0.0004) in the obese patients, but interestingly lower rates of pneumonia (2.4% vs 4.8, P = 0.03) and cerebral vascular accidents (0.0% vs 0.9%, P = 0.05). However, the latter two observations might be explained by more tobacco use among non‐obese patients (26.6 mean pack‐years vs 20.0 mean pack‐years, P = 0.004). Notably, no differences in 30‐day mortality were noted. After adjusting for preoperative demographic and clinical data using propensity score‐matching methods, there were no observed differences between the two cohorts except for operative time ( P = 0.04). Conclusions Obesity is not independently associated with an increased risk of perioperative complications or 30‐day mortality after cystectomy.