All cause 90-day mortality associated with TUR-P procedure: a Swedish quality register-based study (2013-2022)

Prostatic hyperplasia is among the most common urological conditions in ageing men, and transurethral resection of the prostate (TUR-P) has long been the standard surgical treatment. The perioperative mortality rate (POMR) is an important quality indicator for surgical care, yet contemporary national Swedish POMR data associated with TUR-P is lacking.

The primary aim was to assess all-cause mortality up to 90-days following TUR-P in Sweden 2013-2022 and whether there was any temporal trend in POMR. The secondary aim was to assess the impact of patients' characteristics (age, ASA class and indication).

This was an observational, register-based cohort study using data from the Swedish-Perioperative-Register (SPOR). A total of 14,052 TUR-P procedures (KED22) for benign prostatic hyperplasia or prostate cancer were included. Descriptive statistics, ANOVA, chi-square test, and multivariable-logistic regression were applied.

A total of 10 patients died within 30-days (0.07%) and 56 within 90-days (0.4%). No difference in annual POMR was seen over the study-period. Increasing age, higher ASA-class and cancer indication were the only independent predictors of 90-day mortality. Patients aged above 80-years had an OR of 7.9 (95% confidence interval [CI]: 2.2-42.3), ASA 4 had an OR of 12.6 (95% CI: 1.7-94.3), and cancer diagnosis had an OR of 4.4 (95% CI: 2.5-7.9) in the multivariable logistic regression.

POMR following TUR-P in Sweden is low and numerically similar to age-adjusted background mortality in the Swedish population up to the age of 70-years. High age, ASA-class and cancer diagnosis are the strongest predictors of postoperative mortality.