TY - JOUR
T1 - Rhabdomyolysis after major urologic surgery
T2 - Epidemiology, risk factors, and outcomes
AU - Pariser, Joseph J.
AU - Pearce, Shane M.
AU - Patel, Sanjay G.
AU - Anderson, Blake B.
AU - Packiam, Vignesh T.
AU - Shalhav, Arieh L.
AU - Bales, Gregory T.
AU - Smith, Norm D.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Objective To study the epidemiology, risk factors, and outcomes of rhabdomyolysis (RM) after major urologic surgery. Materials and Methods The National Inpatient Sample (2003-2011) was used to identify patients who underwent radical prostatectomy, radical or partial nephrectomy, or radical cystectomy. Demographics included age, sex, race, and comorbidities. Factors examined included bleeding, hospital teaching status, minimally invasive technique, and development of RM. Multivariate logistic regression was used to identify independent risk factors of RM. Outcomes of mortality, acute kidney injury (AKI), length of stay, and charges in patients with RM were compared with those of controls. Results A weighted population of 1,016,074 patients was identified with 870 (0.1%) developing RM, which was significantly more likely for radical or partial nephrectomy and radical cystectomy patients compared with radical prostatectomy patients. On multivariate analysis, independent risk factors for RM included younger age, male sex, diabetes, chronic kidney disease, obesity, and bleeding. Race, minimally invasive technique, and teaching status were not associated with RM when controlling for other factors. Patients with RM experienced increases in mortality, AKI, length of stay, and hospital charges. Conclusion Rhabdomyolysis is a rare complication after urologic surgery. Risk factors include male sex, younger age, diabetes, chronic kidney disease, obesity, and perioperative bleeding. Patients who develop RM have a higher risk of AKI, mortality, prolonged hospital stay, and increased charges.
AB - Objective To study the epidemiology, risk factors, and outcomes of rhabdomyolysis (RM) after major urologic surgery. Materials and Methods The National Inpatient Sample (2003-2011) was used to identify patients who underwent radical prostatectomy, radical or partial nephrectomy, or radical cystectomy. Demographics included age, sex, race, and comorbidities. Factors examined included bleeding, hospital teaching status, minimally invasive technique, and development of RM. Multivariate logistic regression was used to identify independent risk factors of RM. Outcomes of mortality, acute kidney injury (AKI), length of stay, and charges in patients with RM were compared with those of controls. Results A weighted population of 1,016,074 patients was identified with 870 (0.1%) developing RM, which was significantly more likely for radical or partial nephrectomy and radical cystectomy patients compared with radical prostatectomy patients. On multivariate analysis, independent risk factors for RM included younger age, male sex, diabetes, chronic kidney disease, obesity, and bleeding. Race, minimally invasive technique, and teaching status were not associated with RM when controlling for other factors. Patients with RM experienced increases in mortality, AKI, length of stay, and hospital charges. Conclusion Rhabdomyolysis is a rare complication after urologic surgery. Risk factors include male sex, younger age, diabetes, chronic kidney disease, obesity, and perioperative bleeding. Patients who develop RM have a higher risk of AKI, mortality, prolonged hospital stay, and increased charges.
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U2 - 10.1016/j.urology.2015.03.018
DO - 10.1016/j.urology.2015.03.018
M3 - Article
C2 - 26099878
AN - SCOPUS:84931836994
SN - 0090-4295
VL - 85
SP - 1328
EP - 1332
JO - Urology
JF - Urology
IS - 6
ER -