Journal article
Clinical variables associated with major adverse cardiac events following radical cystectomy
BJUI compass, Vol.5(4), pp.480-488
04/2024
DOI: 10.1002/bco2.315
PMCID: PMC11019239
PMID: 38633835
Abstract
Objectives
The objective of this study is to investigate the association between major adverse cardiac events (MACE) and clinical factors of patients undergoing radical cystectomy (RC) for bladder cancer.
Materials and Methods
A retrospective analysis using the 2015–2020 National Surgical Quality Improvement Program database was performed on patients who underwent RC for bladder cancer. MACE was defined as any report of cerebrovascular accident, myocardial infarction, or thromboembolic events (pulmonary embolism or deep vein thrombosis). A multivariable-adjusted logistic regression was conducted to identify clinical predictors of postoperative MACE.
Results
A total of 10 308 (84.2%) patients underwent RC with incontinent urinary diversion (iUD), and 1938 (15.8%) underwent RC with continent urinary diversion (cUD). A total of 629 (5.1%) patients recorded a MACE, and on the multivariable-adjusted logistic regression, it was shown that MACE was significantly associated with increased age (OR = 1.035, 95% CI: 1.024–1.046, p < 0.001), obesity (OR = 1.583, 95% CI: 1.266–1.978, p < 0.001), current smokers (OR = 1.386, 95% CI: 1.130–1.700, p = 0.002), congestive heart failure before surgery (OR = 1.991, 95% CI: 1.016–3.900; p = 0.045), hypertension (OR = 1.209, 95% CI: 1.016–1.453, p = 0.043), and increase the surgical time (per 10 min increase, OR = 1.010, 95% CI: 1.003–1.017, p = 0.009). We also report that increased age, obesity, and patients undergoing cUD (OR = 1.368, 95% CI: 1.040–1.798; p = 0.025) are associated with thromboembolic events.
Conclusion
By considering the preoperative characteristics of patients, including age, obesity, smoking, congestive heart failure, and hypertension status, urologists may be able to decrease the incidence of MACE in patients undergoing RC. Urologists should aim for lower operative times as this was associated with a decreased risk of thromboembolic events.
Details
- Title: Subtitle
- Clinical variables associated with major adverse cardiac events following radical cystectomy
- Creators
- Aaron A. Gurayah - University of MiamiRuben Blachman-Braun - University of MiamiChristopher J. Machado - University of MiamiMatthew M. Mason - University of MiamiHelen Y. Hougen - University of MiamiAli Mouzannar - University of MiamiMark L. Gonzalgo - University of MiamiBruno Nahar - University of MiamiSanoj Punnen - Sylvester Comprehensive Cancer CenterDipen J. Parekh - University of MiamiChad R. Ritch - University of Miami
- Resource Type
- Journal article
- Publication Details
- BJUI compass, Vol.5(4), pp.480-488
- Publisher
- John Wiley and Sons Inc
- DOI
- 10.1002/bco2.315
- PMID
- 38633835
- PMCID
- PMC11019239
- ISSN
- 2688-4526
- eISSN
- 2688-4526
- Number of pages
- 9
- Alternative title
- Gurayah et al
- Language
- English
- Date published
- 04/2024
- Academic Unit
- Urology
- Record Identifier
- 9984701647102771
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