Mp18-19 Impact of Malnutrition on Radical Nephroureterectomy Morbidity and Mortality: Opportunity for Pre-operative Optimization
Year: 2018
Type: article
Study design: Observational Study
Abstract: You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma I1 Apr 2018MP18-19 IMPACT OF MALNUTRITION ON RADICAL NEPHROURETERECTOMY MORBIDITY AND MORTALITY: OPPORTUNITY FOR PRE-OPERATIVE OPTIMIZATION Matthew Katz, Daniel Wollin, Nicholas Donin, Willieam Meeks, Scott Gulig, Lee Zhao, James Wysock, Samir Taneja, William Huang, and Marc Bjurlin Matthew KatzMatthew Katz More articles by this author , Daniel WollinDaniel Wollin More articles by this author , Nicholas DoninNicholas Donin More articles by this author , Willieam MeeksWillieam Meeks More articles by this author , Scott GuligScott Gulig More articles by this author , Lee ZhaoLee Zhao More articles by this author , James WysockJames Wysock More articles by this author , Samir TanejaSamir Taneja More articles by this author , William HuangWilliam Huang More articles by this author , and Marc BjurlinMarc Bjurlin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.595AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Nutritional status is increasingly recognized as an important predictor of prognosis and surgical outcomes in cancer patients. We evaluated the impact of preoperative malnutrition on the development of surgical complications and mortality following radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). METHODS Using data from The American College of Surgeons National Surgical Quality Improvement Program, we evaluated the association of poor nutritional status with 30 day postoperative complications and overall mortality following RNU over years 2005-2015. Preoperative variables suggestive of poor nutritional status included hypoalbuminemia (<3.5 g/dL), weight loss 6 months before surgery (>10%), and low body mass index (BMI). The overall complication rate was calculated, and predictors of complications and mortality were identified using multivariable logistic regression models. RESULTS A total of 1,200 patients were identified who underwent RNU for UTUC. The overall complication rate was 20.5% (n=246) and mortality rate was 1.75% (n=21). On univariate analysis, patients who had a postoperative complication were more likely to have hypoalbuminemia (25.0% vs. 11.4% p<0.001) and weight loss (3.7% vs. 1.0% p=0.003). After controlling for age, sex, race and medical comorbidities, hypoalbuminemia was found to be a significant independent predictor of postoperative complications (OR 2.09 95% CI 1.29-3.38 p=0.003), whereas weight loss and BMI were not significant predictors (Figure 1A). Hypoalbuminemia was also found to be significant independent predictor of mortality (OR 4.31 95% CI 1.45-12.79 p=0.008) on multivariable regression analysis (Figure 1B). CONCLUSIONS Preoperative hypoalbuminemia is a significant predictor of surgical complications and mortality following RNU for UTUC. This finding supports the importance of preoperative nutritional status in this population and suggests that effective nutritional interventions in the preoperative setting could improve patient outcomes. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e221 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Matthew Katz More articles by this author Daniel Wollin More articles by this author Nicholas Donin More articles by this author Willieam Meeks More articles by this author Scott Gulig More articles by this author Lee Zhao More articles by this author James Wysock More articles by this author Samir Taneja More articles by this author William Huang More articles by this author Marc Bjurlin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2795641088