MP64-15 A CRITICAL ANALYSIS OF POSTOPERATIVE MORBIDITY IN MORBIDLY OBESE PATIENTS FOLLOWING RENAL CANCER SURGERY

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy III1 Apr 2016MP64-15 A CRITICAL ANALYSIS OF POSTOPERATIVE MORBIDITY IN MORBIDLY OBESE PATIENTS FOLLOWING RENAL CANCER SURGERY Matthew D. Grimes, Michael L. Blute, Michael A. Mann, Tracy M. Downs, Fangfang Shi, David F. Jarrard, Sara L. Best, Kyle A. Richards, Stephen Y. Nakada, and E. Jason Abel Matthew D. GrimesMatthew D. Grimes More articles by this author , Michael L. BluteMichael L. Blute More articles by this author , Michael A. MannMichael A. Mann More articles by this author , Tracy M. DownsTracy M. Downs More articles by this author , Fangfang ShiFangfang Shi More articles by this author , David F. JarrardDavid F. Jarrard More articles by this author , Sara L. BestSara L. Best More articles by this author , Kyle A. RichardsKyle A. Richards More articles by this author , Stephen Y. NakadaStephen Y. Nakada More articles by this author , and E. Jason AbelE. Jason Abel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.965AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Obesity can make surgery more difficult and increase the risk for postoperative morbidity. Class 3 or morbid obesity (BMI≥40) is the most severe category of obesity using the NIH classification, but few studies have evaluated perioperative outcomes for morbidly obese patients. The objective of this study was to determine if extreme obesity is associated with increased risk of perioperative morbidity following renal cancer surgery. METHODS Data was reviewed for patients with renal neoplasms treated surgically from 2000-2015. Complications according to the Clavien-Dindo system were recorded for 90 days after surgery. Uni/multivariable analysis was used to evaluate if BMI≥40 is associated with perioperative outcomes (complications, 90 day mortality, length of hospital stay (LOS), transfusion rates, and 30 day readmission rates). RESULTS Of 1109 patients undergoing extirpative renal surgery, 114 (10.3%) had BMI≥40 and 280 (25.3%) patients experienced complications within 90 days postoperatively. Patients with BMI≥40 were more likely to be younger (p< 0.01) or have metastatic disease (p=0.02). No baseline differences were identified for patients with BMI≥40 and BMI<40 in lap/robotic vs. open approach, partial/radical/nephro-U, Charlson Comorbidity Index, stage, grade, or presence of venous thrombus. PRBC transfusion was used for 219 (19.8%) patients and median LOS was 4 days (IQR 3-6). Readmission within 30 days occurred in 60 (5.4%) patients and 81(7.3%) patients had major complications (≥Clavien 3). A total of 20 (1.8%) patients died within 90 days of surgery. There was no difference in perioperative outcomes for BMI≥40 (table 1). Overall complication rate was higher for patients with BMI≥40 due to a higher rate of surgical site infections (SSI) for patients with BMI≥40 vs. BMI<40, 10.5% vs. 4.8%, p=0.01. Risk of wound infection was not associated with age, CCI, type of incision, year of surgery, lap/robotic approach, or diabetes diagnosis. After multivariable analysis, BMI≥40 was the only independent predictor of SSI, OR 2.541 (95%CI 1.29-5.01), p=0.007. CONCLUSIONS Extreme obesity (BMI≥40) is associated with increased risk of surgical site infection but not with major complications, blood transfusion, LOS, readmission, or 90day mortality following renal extirpative surgery. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e835-e836 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Matthew D. Grimes More articles by this author Michael L. Blute More articles by this author Michael A. Mann More articles by this author Tracy M. Downs More articles by this author Fangfang Shi More articles by this author David F. Jarrard More articles by this author Sara L. Best More articles by this author Kyle A. Richards More articles by this author Stephen Y. Nakada More articles by this author E. Jason Abel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...