Journal article
Wound dehiscence in a sample of 1 776 cystectomies: identification of predictors and implications for outcomes
BJU international, Vol.117(6B), pp.E95-E101
06/01/2016
DOI: 10.1111/bju.13213
PMID: 26118393
Abstract
Objective
To investigate the incidence and predictors of wound dehiscence in patients undergoing radical cystectomy (RC).
Patients and Methods
In all, 1 776 patient records with Current Procedural Terminology (CPT) codes for radical cystectomy (RC) were extracted from the American College of Surgeons National Quality Improvement Program (ACS-NSQIP) between 2005 and 2012. Stratification was made based on the occurrence of postoperative wound dehiscence, defined as loss of integrity of fascial closure. Descriptive and logistic regression models were used to identify predictors of postoperative wound dehiscence. The implications of wound dehiscence on peri-and postoperative outcomes such as complications, mortality, prolonged length of stay (>11 days), and prolonged operative time (>411 min), were assessed.
Results
Of 1 776 patients analysed, 57 (3.2%) had a documented wound dehiscence. In multivariable analyses, chronic obstructive pulmonary disease (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.0-4.0; P = 0.03) and high body mass index (OR 2.3, 95% CI 1.3-4.4; P = 0.008) were significant predictors of wound dehiscence. While female gender had significantly lower proportions of wound dehiscence, multivariable analyses did not confirm this (OR 0.4, 95% CI 0.4-1.4; P = 0.75).
Conclusions
Our study is the first to identify predictors of wound dehiscence after RC in a large, contemporary multi-institutional cohort. Identifying patients at risk of postoperative wound complications may guide the use of preventative measures at the time of surgery.
Details
- Title: Subtitle
- Wound dehiscence in a sample of 1 776 cystectomies: identification of predictors and implications for outcomes
- Creators
- Christian P. Meyer - Brigham and Women's HospitalArturo J. Rios Diaz - Brigham and Women's HospitalDeepansh Dalela - Henry Ford Health SystemJulian Hanske - Brigham and Women's HospitalDaniel Pucheril - Henry Ford Health SystemMarianne Schmid - University Medical Center Hamburg-EppendorfVincent Q. Trinh - Université de MontréalJesse D. Sammon - Henry Ford Health SystemMani Menon - Henry Ford Health SystemFelix K. H. Chun - Univ Med Ctr Hamburg Eppendorf, Dept Urol, Hamburg, GermanyJoachim Noldus - Universitätsklinik Marien Hospital HerneMargit Fisch - University Medical Center Hamburg-EppendorfQuoc-Dien Trinh - Harvard University
- Resource Type
- Journal article
- Publication Details
- BJU international, Vol.117(6B), pp.E95-E101
- DOI
- 10.1111/bju.13213
- PMID
- 26118393
- NLM abbreviation
- BJU Int
- ISSN
- 1464-4096
- eISSN
- 1464-410X
- Publisher
- Wiley
- Number of pages
- 7
- Language
- English
- Date published
- 06/01/2016
- Academic Unit
- Urology
- Record Identifier
- 9984949201302771
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