The role of body mass index on quality indicators following minimally-invasive radical prostatectomy

Ram A. Pathak; Robert R.A. Wilson; Timothy E. Craven; Ethan Matz; Ashok K. Hemal

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자료유형: 학술저널

저자정보: Ram A. Pathak (Wake Forest University Baptist Medical Center) Robert R.A. Wilson (Wake Forest University Baptist Medical Center) Timothy E. Craven (Wake Forest University Baptist Medical Center) Ethan Matz (Wake Forest University Baptist Medical Center) Ashok K. Hemal (Wake Forest University Baptist Medical Center)

저널정보: 대한비뇨기과학회 Investigative and Clinical Urology Investigative and Clinical Urology Vol.62 No.3

발행연도: 2021.1

수록면: 290 - 297 (8page)

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Purpose: We sought to determine the role of body mass index (BMI) on quality indicators, such as length of stay and readmission. The National Surgical Quality Improvement Program (NSQIP) database was queried to examine the effect of obesity, defined as BMI >30, on outcomes after Minimally Invasive Radical Retropubic Prostatectomy (MI-RRP). Materials and Methods: Utilizing the NSQIP database, patient records were identified using the Current Procedural Terminology (CPT) code 55866 (laparoscopy, surgical prostatectomy, radical retropubic) during a 10-year period (2007–2017). Obesity was classified according to the CDC classification. Chi-square tests were utilized to evaluate BMI distribution by surgery year. Logistic regression was used to evaluate the relationship of BMI with length of stay (LOS) and hospital readmission within 30 days, after controlling for preoperative variables. Results: Records of 49,238 patients who have undergone MI-RRP during 2007–2017 were evaluated. Mean yearly BMI rose from 28.5 to 29.2, while the percentage of surgical patients with BMI >30 rose by 5% (33% to 38%; p<0.0001) over the study period. Obese patients demonstrated higher morbidity, prolonged LOS, and increased readmission rates after MI-RRP. Obesity severity correlated negatively with quality indicators in a graded fashion. Conclusions: Obesity rates in patients undergoing MI-RRP increased from 2007–2017. Obese patients are at increased risk of morbidity, prolonged LOS, and readmission within 30 days, following MI-RRP. These patients should not be excluded from MI-RRP; rather, physicians should discuss these increased risks with their patients. Proper weight loss strategies should be instituted preoperatively to mitigate these risks.

#Body mass index #Laparoscopy #Patient readmission #Postoperative complications #Prostatectomy

참고문헌 (30)

참고문헌 신청

World Health Organization / Obesity and overweight

Centers for Disease Control and Prevention / Defining adult overweight and obesity

Chooi YC / 2019 / The epidemiology of obesity / Metabolism 92:6~10

Hales CM / 2017 / Prevalence of obesity among adults and youth: United States, 2015-2016 / NCHS Data Brief 288:1~8

Kim DD / 2016 / Estimating the medical care costs of obesity in the United States : systematic review, meta-analysis, and empirical analysis / Value Health 19:602~613

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