Age-stratified perioperative mortality after urological surgeries
Brendan Wallace1, Rodney H Breau1,2, Sonya Cnossen1
1Division of Urology, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
Summary
Mortality risk increases with age and open surgical approaches in urology. Understanding these risks helps select patients and improve counseling for urological surgeries.
Area of Science:
- Urology
- Surgical Outcomes
- Geriatric Medicine
Background:
- Increasing number of elderly patients seek surgical consultations.
- Assessing mortality risk by age group after urological surgery is crucial for patient care.
Purpose of the Study:
- To analyze the 30-day mortality risk associated with common urological procedures in elderly patients.
- To compare mortality risks between open and minimally invasive (laparoscopic/robotic) surgical approaches.
Main Methods:
- Historical cohort study utilizing the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database (2006-2015).
- Grouped Current Procedural Terminology (CPT) codes for similar urological procedures.
- Stratified outcomes by patient age and surgical approach (open vs. laparoscopic/robotic).
Main Results:
- Reviewed 12 urological procedures involving 124,262 patients; 0.8% experienced 30-day mortality.
- Open nephroureterectomy had the highest mortality (2.9%).
- Patients aged 80+ undergoing open radical nephrectomy faced the highest mortality risk (5.32%); mortality increased with age and was higher for open procedures.
Conclusions:
- Mortality risk in urological surgery escalates with patient age and open surgical techniques.
- Data on absolute mortality risk for common urological surgeries can enhance patient selection and counseling.
Related Concept Videos
01:16Stratified Sampling Method
15.5K
Sampling is a technique to select a portion (or subset) of the larger population and study that portion (the sample) to gain information about the population. The sampling method ensures that samples are drawn without bias and accurately represent the population. Because measuring the entire population in a study is not practical, researchers use samples to represent the population of interest.
To choose a stratified sample, divide the population into groups called strata and then take a...
To choose a stratified sample, divide the population into groups called strata and then take a...
15.5K
01:28Urologic Endoscopic Procedure: Cystoscopic Examination
3.4K
Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
3.4K
01:26Aging
801
Aging is a complex biological phenomenon influenced by various processes that affect cellular and systemic functions. Several prominent theories attempt to explain its mechanisms, highlighting cellular limitations, oxidative damage, and hormonal changes as central factors in aging.
Cellular Clock Theory
The cellular clock theory posits that the human lifespan is closely tied to the finite capacity of cells to divide, a phenomenon governed by telomeres, which are protective caps at the ends of...
Cellular Clock Theory
The cellular clock theory posits that the human lifespan is closely tied to the finite capacity of cells to divide, a phenomenon governed by telomeres, which are protective caps at the ends of...
801
01:29Classification of Epithelial Tissues: Stratified Epithelium
13.1K
Stratified epithelium consists of several stacked layers of cells. They provide the durability to withstand constant physical and chemical attacks. Stratified epithelium is named after the shape of the most apical layer of cells. Stratified squamous epithelium is the most common type found in the human body. In this tissue, the apical cells are squamous, whereas the basal layer contains either columnar or cuboidal cells. The basal cells divide to form new daughter cells, which gradually become...
13.1K
01:19The Effect of Aging on Tissues
3.6K
Several body functions deteriorate with age. The external signs of aging are easily identifiable. For example, the skin becomes dry, less elastic, and thins out, forming wrinkles. The skin of the face begins to appear looser due to a decrease in the levels of elastic and collagen fibers in the connective tissue. Additionally, melanin production in the hair follicle decreases with age, resulting in gray hair. Moreover, the senses of sight and hearing decline, so glasses and hearing aids may...
3.6K
01:09Changes in the Appendicular Skeleton with Age
3.6K
The upper and lower limb initially develops as a small bulge called a limb bud, which appears on the lateral side of the early embryo. The upper limb bud appears near the end of the fourth week of development, with the lower limb bud appearing shortly after.
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
3.6K