Abstract
OBJECTIVE: To ascertain contemporary overall and differential thirty-day mortality (TDM) rates after all types of nephrectomy in the UK, and to identify potential new risk factors for death.
PATIENTS AND METHODS: We conducted a retrospective analysis of the 110 deaths that occurred within 30 days of surgery out of the total of 21 380 nephrectomies performed, and calculated the odds ratio (OR) and 95% confidence interval (CI) for TDM based on peri-operative characteristics.
RESULTS: The overall TDM rate was 110/21380 (0.5%). The TDM rates after radical, partial, simple nephrectomy and nephro-ureterectomy were 0.6% (63/11057), 0.1% (4/3931), 0.4% (11/2819) and 0.9% (28/3091), respectively. TDM increased with age, stage, estimated blood loss (EBL), operating time and performance status. EBL of 1-2 L was associated with a greater risk of TDM than EBL of 2-5 L (OR 1.38; 95% CI 1.03-2.24). Conversion from minimally invasive surgery was associated with higher risk than non-conversion (OR 2.53; 95% CI 1.14-4.51. Curative surgery was safer than cytoreductive surgery (OR 0.31; 95% CI 0.18-0.54). There was an association between surgical volume and TDM.
CONCLUSIONS: This study provides contemporary insights into the true risks of all types of nephrectomy. The TDM rate after nephrectomy in the UK appears acceptably low at 0.5%. Established risk factors were confirmed and the following novel risk factors were identified: modest EBL (1-2 L) and conversion from minimally invasive surgery.
Original language | English |
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Pages (from-to) | 358-364 |
Number of pages | 7 |
Journal | BJU International |
Volume | 120 |
Issue number | 3 |
Early online date | 24 Apr 2017 |
DOIs | |
Publication status | Published - Sept 2017 |
Externally published | Yes |
Bibliographical note
© 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.Keywords
- Aged
- Aged, 80 and over
- Female
- Humans
- Kidney Neoplasms/mortality
- Male
- Middle Aged
- Nephrectomy/mortality
- Retrospective Studies
- Risk Factors