The Effect of Obesity on Perioperative Outcomes Following Percutaneous Nephrolithotomy

Vincent Trudeau, Pierre I. Karakiewicz, Katharina Boehm, Paolo Dell'Oglio, Zhe Tian, Alberto Briganti, Shahrokh F. Shariat, Luc Valiquette, Naeem Bhojani

Research output: Contribution to journalArticle

Abstract

Objectives: To test if obesity predisposes to higher rates of adverse outcomes after percutaneous nephrolithotomy (PCNL). Materials and Methods: Within the Nationwide Inpatient Sample (NIS), we identified patients treated with PCNL between 1998 and 2010 for kidney stones. We examined the temporal trends in PCNL use and charges among obese and nonobese patients. We then tested the effect of obesity on perioperative complications, transfusions, length of stay (LOS), and total hospital charges (THCs). LOS and THCs were defined as a continuous variable and were also dichotomized according to the 75th percentile into prolonged LOS (pLOS) and increased THCs (iTHCs). Then, multivariable models were fitted. Results: Overall, a weighted sample of 90,529 individuals treated with PCNL between 1998 and 2010 was examined. Of those patients, 9300 were obese (10.3%). The proportion of PCNLs performed in obese patients increased throughout the years from 7.4% to 16.7% (p <0.001). Overall complication rates were 21.6% vs 22.0% (p = 0.3) and transfusion rates were 4.3% vs 4.0% (p = 0.1) for obese and nonobese patients, respectively. Obese patients had fewer genitourinary complications (13.4% vs 15.0%, p <0.001), but had higher rates of sepsis (1.7% vs 1.3%, p = 0.009) as well as respiratory (3.0% vs 2.5%, p = 0.002) and vascular complications (0.3% vs 0.2%, p = 0.007). Conversely, pLOS (20.9% vs 18.8%, p <0.001) and iTHCs (30.8% vs 24.4%, p <0.001) were more frequently recorded in obese patients. In multivariable analyses, obesity was neither associated with higher rates of overall complications (odds ratio [OR], p = 0.3) nor with higher rates of transfusions (p = 0.3). However, obesity was associated with pLOS (OR: 1.21, p = 0.002) as well as iTHCs (OR: 1.17, p = 0.002). Conclusions: PCNL in obese patients did not result in higher rates of individual complications or transfusions. However, it resulted in higher rates of pLOS and iTHCs.

Original languageEnglish
Pages (from-to)864-870
Number of pages7
JournalJournal of Endourology
Volume30
Issue number8
DOIs
Publication statusPublished - Aug 1 2016

ASJC Scopus subject areas

  • Medicine(all)
  • Urology

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    Trudeau, V., Karakiewicz, P. I., Boehm, K., Dell'Oglio, P., Tian, Z., Briganti, A., Shariat, S. F., Valiquette, L., & Bhojani, N. (2016). The Effect of Obesity on Perioperative Outcomes Following Percutaneous Nephrolithotomy. Journal of Endourology, 30(8), 864-870. https://doi.org/10.1089/end.2015.0789