TY - JOUR
T1 - HoLEP Safety and Efficacy in Octogenarians
T2 - A Retrospective ACS-NSQIP Analysis (2011-2020)
AU - Dalla, Emad Eddin
AU - Bhandari, Mukund
AU - Abdelaziz, Ahmad
AU - Trecarten, Shaun
AU - Liss, Michael
AU - Mansour Elkenany, Ahmed M
N1 - Publisher Copyright:
© 2024
PY - 2024
Y1 - 2024
N2 - Objective: To evaluate the safety of Holmium laser enucleation of the prostate (HoLEP) in octogenarian compared to non-octogenarian patients. Methods: A retrospective cohort analysis was performed using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2011 to 2020. We assessed baseline demographic data, American Society of Anesthesiologists (ASA) score, functional status, and medical comorbidities. Our primary outcome was the incidence of postoperative complications, the need for re-operation, and readmission within 30 days following the procedure between octogenarians and non-octogenarians. A multivariate logistic model was utilized to identify predictors for postoperative complications. Results: A total of 5305 patients were included. Octogenarians had higher rates of hypertension (69.9% vs 55.5%, P <.001), and bleeding disorders (5.1% vs 2.6%, P <.001). The absolute risk for postoperative complications was low in the 2 groups. However, the octogenarians had higher rates for readmitted (6.1% vs 3.6% P = .006) and to receive perioperative blood transfusion (3.3% vs 0.9% P-value <.001). Multivariable regression analysis showed a significantly lower odds ratio to develop complications in non-octogenarians (OR: 0.698) (95% CI: 0.537, 0.908, [P = .007]). Conclusion: There was a significant association between octogenarians and the risk of postoperative complications of HoLEP, however, the absolute risk remained low. We believe that operative outcomes for octogenarians can be optimized with careful selection given the low incidence of complications.
AB - Objective: To evaluate the safety of Holmium laser enucleation of the prostate (HoLEP) in octogenarian compared to non-octogenarian patients. Methods: A retrospective cohort analysis was performed using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2011 to 2020. We assessed baseline demographic data, American Society of Anesthesiologists (ASA) score, functional status, and medical comorbidities. Our primary outcome was the incidence of postoperative complications, the need for re-operation, and readmission within 30 days following the procedure between octogenarians and non-octogenarians. A multivariate logistic model was utilized to identify predictors for postoperative complications. Results: A total of 5305 patients were included. Octogenarians had higher rates of hypertension (69.9% vs 55.5%, P <.001), and bleeding disorders (5.1% vs 2.6%, P <.001). The absolute risk for postoperative complications was low in the 2 groups. However, the octogenarians had higher rates for readmitted (6.1% vs 3.6% P = .006) and to receive perioperative blood transfusion (3.3% vs 0.9% P-value <.001). Multivariable regression analysis showed a significantly lower odds ratio to develop complications in non-octogenarians (OR: 0.698) (95% CI: 0.537, 0.908, [P = .007]). Conclusion: There was a significant association between octogenarians and the risk of postoperative complications of HoLEP, however, the absolute risk remained low. We believe that operative outcomes for octogenarians can be optimized with careful selection given the low incidence of complications.
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U2 - 10.1016/j.urology.2024.10.070
DO - 10.1016/j.urology.2024.10.070
M3 - Article
C2 - 39643049
AN - SCOPUS:85211743511
SN - 0090-4295
JO - Urology
JF - Urology
ER -