Hospital volume is a determinant of postoperative complications, blood transfusion and length of stay after radical or partial nephrectomy

Maxine Sun, Marco Bianchi, Quoc Dien Trinh, Firas Abdollah, Jan Schmitges, Claudio Jeldres, Shahrokh F. Shariat, Markus Graefen, Francesco Montorsi, Paul Perrotte, Pierre I. Karakiewicz

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Abstract

We examined the impact of hospital volume on short-term outcomes after nephrectomy for nonmetastatic renal cell carcinoma. Using the Nationwide Inpatient Sample we identified 48,172 patients with nonmetastatic renal cell carcinoma treated with nephrectomy (1998 to 2007). Postoperative complications, blood transfusions, prolonged length of stay and in-hospital mortality were examined. Stratification was performed according to teaching status, nephrectomy type (partial vs radical nephrectomy) and surgical approach (open vs laparoscopic). Multivariable logistic regression models were fitted. Patients treated at high volume centers were younger and healthier at nephrectomy. High hospital volume predicted lower blood transfusion rates (8.5% vs 9.7% vs 11.8%), postoperative complications (14.4% vs 16.6% vs 17.2%) and shorter length of stay (43.1% vs 49.8% vs 54.0%, all p 0.05) and blood transfusions in nephrectomies performed laparoscopically (OR 0.68, p >0.05). On average, high hospital volume results in more favorable outcomes during hospitalization after nephrectomy.

Original languageEnglish
Pages (from-to)405-410
Number of pages6
JournalJournal of Urology
Volume187
Issue number2
DOIs
Publication statusPublished - Feb 2012

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Keywords

  • carcinoma
  • health facility size
  • morbidity
  • nephrectomy
  • renal cell
  • teaching

ASJC Scopus subject areas

  • Urology

Cite this

Sun, M., Bianchi, M., Trinh, Q. D., Abdollah, F., Schmitges, J., Jeldres, C., Shariat, S. F., Graefen, M., Montorsi, F., Perrotte, P., & Karakiewicz, P. I. (2012). Hospital volume is a determinant of postoperative complications, blood transfusion and length of stay after radical or partial nephrectomy. Journal of Urology, 187(2), 405-410. https://doi.org/10.1016/j.juro.2011.10.025