TY - JOUR
T1 - Minimally invasive cystectomy is associated with improved perioperative patient safety outcomes compared with open cystectomy in a national cohort
AU - Cohen, Seth A.
AU - Mirheydar, Hossein S.
AU - Parsons, J. Kellogg
AU - Palazzi, Kerrin L.
AU - Liss, Michael A.
AU - Chang, David C.
AU - Kane, Christopher J.
AU - Kader, A. Karim
PY - 2014/8
Y1 - 2014/8
N2 - Objective To compare perioperative patient safety outcomes of minimally invasive cystectomy (MIC) with open cystectomy (OC) in a national cohort. Comparative outcomes data based on validated metrics are sparse for MIC, an emerging treatment for bladder cancer. Methods We identified patients undergoing MIC and OC for bladder cancer from 2005 to 2010 using the US Nationwide Inpatient Sample. We compared perioperative outcomes using Patient Safety Indicators (PSIs), validated metrics developed by the Agency for Healthcare Research and Quality, and used multivariate regression analyses to generate adjusted odds ratios. Results Between 2005 and 2010, 42,919 patients underwent cystectomy. During this period, the prevalence of MIC increased from 0.8% to 10.3% of all cystectomies. Compared with OC, MIC patients were more likely to be male (P =.019) and treated at large teaching hospitals (P <.001). There were no significant differences in age, race, Charlson index, or region between groups. The median lengths of stay were 8 and 7 days for OC and MIC, respectively (P <.001). In multivariate regression analyses, MIC was associated with a 30% decreased likelihood of any PSI (odds ratio, 0.71; P =.038). Although the occurrence of any PSI was associated with increased mortality (P <.001), there were no significant differences in mortality between OC and MIC. Conclusion The prevalence of MIC has substantially increased in recent years. Patients undergoing MIC had superior perioperative patient safety outcomes as measured by PSIs. Further study is needed to explain these patterns and to promote the continued safe diffusion of this technology.
AB - Objective To compare perioperative patient safety outcomes of minimally invasive cystectomy (MIC) with open cystectomy (OC) in a national cohort. Comparative outcomes data based on validated metrics are sparse for MIC, an emerging treatment for bladder cancer. Methods We identified patients undergoing MIC and OC for bladder cancer from 2005 to 2010 using the US Nationwide Inpatient Sample. We compared perioperative outcomes using Patient Safety Indicators (PSIs), validated metrics developed by the Agency for Healthcare Research and Quality, and used multivariate regression analyses to generate adjusted odds ratios. Results Between 2005 and 2010, 42,919 patients underwent cystectomy. During this period, the prevalence of MIC increased from 0.8% to 10.3% of all cystectomies. Compared with OC, MIC patients were more likely to be male (P =.019) and treated at large teaching hospitals (P <.001). There were no significant differences in age, race, Charlson index, or region between groups. The median lengths of stay were 8 and 7 days for OC and MIC, respectively (P <.001). In multivariate regression analyses, MIC was associated with a 30% decreased likelihood of any PSI (odds ratio, 0.71; P =.038). Although the occurrence of any PSI was associated with increased mortality (P <.001), there were no significant differences in mortality between OC and MIC. Conclusion The prevalence of MIC has substantially increased in recent years. Patients undergoing MIC had superior perioperative patient safety outcomes as measured by PSIs. Further study is needed to explain these patterns and to promote the continued safe diffusion of this technology.
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U2 - 10.1016/j.urology.2014.02.048
DO - 10.1016/j.urology.2014.02.048
M3 - Article
C2 - 24958477
AN - SCOPUS:84905113412
SN - 0090-4295
VL - 84
SP - 314
EP - 320
JO - Urology
JF - Urology
IS - 2
ER -