Alcohol Use Disorder versus Adverse In-Hospital Outcomes after Radical Cystectomy and Ileal Conduit Urinary Diversion

Area of Science:

• Urology
• Oncology
• Addiction Medicine

Background:

• Radical cystectomy (RC) is the standard treatment for muscle-invasive bladder cancer (BCa).
• Alcohol use disorder (AUD) is a potential risk factor for adverse in-hospital outcomes after RC.
• This study investigates the impact of AUD on outcomes following RC and ileal conduit urinary diversion.

Purpose of the Study:

• To evaluate the association between alcohol use disorder (AUD) and in-hospital outcomes in patients undergoing radical cystectomy (RC) for bladder cancer (BCa).
• To identify specific adverse outcomes associated with AUD in this patient population.

Main Methods:

• Retrospective analysis of the National Inpatient Sample (2006-2019) database.
• Inclusion of patients who underwent RC and ileal conduit urinary diversion for BCa.
• Application of descriptive analyses, propensity score matching (PSM), and multivariable regression models to assess outcomes in patients with and without a history of AUD.

Main Results:

• A history of AUD was identified in 2.1% of 15,018 patients undergoing RC.
• Patients with AUD had significantly higher rates of 9 adverse in-hospital outcomes, including critical care, overall complications, prolonged length of stay, pulmonary, acute kidney injury, hepatic, in-hospital mortality, cardiac complications, and total hospital charges.
• AUD independently predicted increased rates of these adverse outcomes, with odds ratios ranging from 1.2 to 3.3 (p < 0.01).

Conclusions:

• Alcohol use disorder (AUD) is significantly associated with increased adverse in-hospital outcomes and mortality after radical cystectomy (RC) and ileal conduit urinary diversion.
• Precautionary measures before and during hospitalization are advisable for patients with AUD undergoing RC.
• Further research may explore targeted interventions to mitigate risks in this patient group.