Who is at risk of death from nephrectomy? An analysis of thirty‐day mortality after 21 380 nephrectomies in 3 years of the British Association of Urological Surgeons (BAUS) National Nephrectomy Audit
Objective To ascertain contemporary overall and differential thirty‐day mortality (TDM) rates after all types of nephrectomy in the UK, and to identify potential new risk factors for death. Patients and Methods We conducted a retrospective analysis of the 110 deaths that occurred within 30 days of s...
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| Veröffentlicht in: | BJU international 2017-09, Vol.120 (3), p.358-364 |
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| creator | Fernando, Archie Afzal, N. Aho, T. F. Al‐Akraa, M. Al‐Sudani, M. Almond, D. J. Apakama, I. Banerjee, G. K. Barber, N. J. Biyani, C. S. Blacker, A. J. Blake, C. Boddy, J. Bromage, S. J. Burgess, N. A. Burns‐Cox, N. Bycroft, J. Calleary, J. G. Calvert, R. C. Campbell, C. A. Cannon, A. Cartledge, J. J. Chakravarti, A. Chen, T. F. Choi, W. H. Clavijo Eisele, J. Cole, O. J. Cooksey, G. Cornaby, A. J. Cornford, P. A. Corr, J. G. Coulthard, R. Crundwell, M. C. Davenport, K. Dickerson, D. A. G. Eddy, B. Elsaghir, M. Fiala, R. Fordham, M. V. P. Gall, Z. J. Gallegos, C. R. R. Garnett, S. Ghei, M. Gibbons, N. Godbole, H. C. Golash, A. Goodman, C. M. Gowardhan, B. Gunendran, T. Haldar, N. Hanbury, D. C. Hicks, J. A. Hodgson, D. J. Ilie, C. Johnson, M. I. Jones, A. Joshi, H. Joyce, A. D. Kanaga‐Sundaram, S. Larner, T. Latif, Z. Lewis, G. Lynn, N. N. K. Mackie, S. Maddineni, S.B. Makar, A. A. Manikandan, R. Mantle, M. McNeill, S. A. Mellon, J. K. Motiwala, H. G. Munro, N. Namasivayam, S. Nathan, S. O'Brien, T. S. O'Riordan, A. Oades, G. Okeke, A. A. Phillips, S. M. A. Ramani, V. A. C. Rane, A. Ravi, R. Ravichandran, S. Rimington, P. D. Robinson, L. Q. Rogers, A. G. Sandhu, S. Shah, Z. Sherwood, B. Singh, S. Subramonian, K. Thilagarajah, R. Thomas, B. Umez‐Eronini, O. N. Varadaraj, H. Walton, T. Wedderburn, A. Weston, R. Wills, M. I. Yates, D. R. |
| description | Objective
To ascertain contemporary overall and differential thirty‐day mortality (TDM) rates after all types of nephrectomy in the UK, and to identify potential new risk factors for death.
Patients and Methods
We conducted a retrospective analysis of the 110 deaths that occurred within 30 days of surgery out of the total of 21 380 nephrectomies performed, and calculated the odds ratio (OR) and 95% confidence interval (CI) for TDM based on peri‐operative characteristics.
Results
The overall TDM rate was 110/21380 (0.5%). The TDM rates after radical, partial, simple nephrectomy and nephro‐ureterectomy were 0.6% (63/11057), 0.1% (4/3931), 0.4% (11/2819) and 0.9% (28/3091), respectively. TDM increased with age, stage, estimated blood loss (EBL), operating time and performance status. EBL of 1–2 L was associated with a greater risk of TDM than EBL of 2–5 L (OR 1.38; 95% CI 1.03–2.24). Conversion from minimally invasive surgery was associated with higher risk than non‐conversion (OR 2.53; 95% CI 1.14–4.51. Curative surgery was safer than cytoreductive surgery (OR 0.31; 95% CI 0.18–0.54). There was an association between surgical volume and TDM.
Conclusions
This study provides contemporary insights into the true risks of all types of nephrectomy. The TDM rate after nephrectomy in the UK appears acceptably low at 0.5%. Established risk factors were confirmed and the following novel risk factors were identified: modest EBL (1–2 L) and conversion from minimally invasive surgery. |
| doi_str_mv | 10.1111/bju.13842 |
| format | Article |
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To ascertain contemporary overall and differential thirty‐day mortality (TDM) rates after all types of nephrectomy in the UK, and to identify potential new risk factors for death.
Patients and Methods
We conducted a retrospective analysis of the 110 deaths that occurred within 30 days of surgery out of the total of 21 380 nephrectomies performed, and calculated the odds ratio (OR) and 95% confidence interval (CI) for TDM based on peri‐operative characteristics.
Results
The overall TDM rate was 110/21380 (0.5%). The TDM rates after radical, partial, simple nephrectomy and nephro‐ureterectomy were 0.6% (63/11057), 0.1% (4/3931), 0.4% (11/2819) and 0.9% (28/3091), respectively. TDM increased with age, stage, estimated blood loss (EBL), operating time and performance status. EBL of 1–2 L was associated with a greater risk of TDM than EBL of 2–5 L (OR 1.38; 95% CI 1.03–2.24). Conversion from minimally invasive surgery was associated with higher risk than non‐conversion (OR 2.53; 95% CI 1.14–4.51. Curative surgery was safer than cytoreductive surgery (OR 0.31; 95% CI 0.18–0.54). There was an association between surgical volume and TDM.
Conclusions
This study provides contemporary insights into the true risks of all types of nephrectomy. The TDM rate after nephrectomy in the UK appears acceptably low at 0.5%. Established risk factors were confirmed and the following novel risk factors were identified: modest EBL (1–2 L) and conversion from minimally invasive surgery.</description><identifier>ISSN: 1464-4096</identifier><identifier>EISSN: 1464-410X</identifier><identifier>DOI: 10.1111/bju.13842</identifier><identifier>PMID: 28440053</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Aged ; Aged, 80 and over ; Audit objectives ; death ; Female ; Humans ; kidney cancer ; Kidney Neoplasms - mortality ; Kidney Neoplasms - surgery ; Laparoscopy ; Male ; Middle Aged ; Minimally invasive surgery ; Mortality ; national audit ; Nephrectomy ; Nephrectomy - mortality ; Nephrectomy - statistics & numerical data ; nephro‐ureterectomy ; partial nephrectomy ; radical nephrectomy ; Retrospective Studies ; Risk Factors ; simple nephrectomy ; Surgery</subject><ispartof>BJU international, 2017-09, Vol.120 (3), p.358-364</ispartof><rights>2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd</rights><rights>2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.</rights><rights>BJUI © 2017 BJU International</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3882-45f077e764035ad40e03f63ddf727d7013313471f1fe061b315e52ab03211db93</citedby><cites>FETCH-LOGICAL-c3882-45f077e764035ad40e03f63ddf727d7013313471f1fe061b315e52ab03211db93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbju.13842$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbju.13842$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28440053$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fernando, Archie</creatorcontrib><creatorcontrib>Afzal, N.</creatorcontrib><creatorcontrib>Aho, T. F.</creatorcontrib><creatorcontrib>Al‐Akraa, M.</creatorcontrib><creatorcontrib>Al‐Sudani, M.</creatorcontrib><creatorcontrib>Almond, D. J.</creatorcontrib><creatorcontrib>Apakama, I.</creatorcontrib><creatorcontrib>Banerjee, G. K.</creatorcontrib><creatorcontrib>Barber, N. J.</creatorcontrib><creatorcontrib>Biyani, C. S.</creatorcontrib><creatorcontrib>Blacker, A. J.</creatorcontrib><creatorcontrib>Blake, C.</creatorcontrib><creatorcontrib>Boddy, J.</creatorcontrib><creatorcontrib>Bromage, S. J.</creatorcontrib><creatorcontrib>Burgess, N. A.</creatorcontrib><creatorcontrib>Burns‐Cox, N.</creatorcontrib><creatorcontrib>Bycroft, J.</creatorcontrib><creatorcontrib>Calleary, J. G.</creatorcontrib><creatorcontrib>Calvert, R. C.</creatorcontrib><creatorcontrib>Campbell, C. A.</creatorcontrib><creatorcontrib>Cannon, A.</creatorcontrib><creatorcontrib>Cartledge, J. J.</creatorcontrib><creatorcontrib>Chakravarti, A.</creatorcontrib><creatorcontrib>Chen, T. F.</creatorcontrib><creatorcontrib>Choi, W. H.</creatorcontrib><creatorcontrib>Clavijo Eisele, J.</creatorcontrib><creatorcontrib>Cole, O. J.</creatorcontrib><creatorcontrib>Cooksey, G.</creatorcontrib><creatorcontrib>Cornaby, A. J.</creatorcontrib><creatorcontrib>Cornford, P. A.</creatorcontrib><creatorcontrib>Corr, J. G.</creatorcontrib><creatorcontrib>Coulthard, R.</creatorcontrib><creatorcontrib>Crundwell, M. C.</creatorcontrib><creatorcontrib>Davenport, K.</creatorcontrib><creatorcontrib>Dickerson, D. A. G.</creatorcontrib><creatorcontrib>Eddy, B.</creatorcontrib><creatorcontrib>Elsaghir, M.</creatorcontrib><creatorcontrib>Fiala, R.</creatorcontrib><creatorcontrib>Fordham, M. V. P.</creatorcontrib><creatorcontrib>Gall, Z. J.</creatorcontrib><creatorcontrib>Gallegos, C. R. R.</creatorcontrib><creatorcontrib>Garnett, S.</creatorcontrib><creatorcontrib>Ghei, M.</creatorcontrib><creatorcontrib>Gibbons, N.</creatorcontrib><creatorcontrib>Godbole, H. C.</creatorcontrib><creatorcontrib>Golash, A.</creatorcontrib><creatorcontrib>Goodman, C. M.</creatorcontrib><creatorcontrib>Gowardhan, B.</creatorcontrib><creatorcontrib>Gunendran, T.</creatorcontrib><creatorcontrib>Haldar, N.</creatorcontrib><creatorcontrib>Hanbury, D. C.</creatorcontrib><creatorcontrib>Hicks, J. A.</creatorcontrib><creatorcontrib>Hodgson, D. J.</creatorcontrib><creatorcontrib>Ilie, C.</creatorcontrib><creatorcontrib>Johnson, M. I.</creatorcontrib><creatorcontrib>Jones, A.</creatorcontrib><creatorcontrib>Joshi, H.</creatorcontrib><creatorcontrib>Joyce, A. D.</creatorcontrib><creatorcontrib>Kanaga‐Sundaram, S.</creatorcontrib><creatorcontrib>Larner, T.</creatorcontrib><creatorcontrib>Latif, Z.</creatorcontrib><creatorcontrib>Lewis, G.</creatorcontrib><creatorcontrib>Lynn, N. N. K.</creatorcontrib><creatorcontrib>Mackie, S.</creatorcontrib><creatorcontrib>Maddineni, S.B.</creatorcontrib><creatorcontrib>Makar, A. A.</creatorcontrib><creatorcontrib>Manikandan, R.</creatorcontrib><creatorcontrib>Mantle, M.</creatorcontrib><creatorcontrib>McNeill, S. A.</creatorcontrib><creatorcontrib>Mellon, J. K.</creatorcontrib><creatorcontrib>Motiwala, H. G.</creatorcontrib><creatorcontrib>Munro, N.</creatorcontrib><creatorcontrib>Namasivayam, S.</creatorcontrib><creatorcontrib>Nathan, S.</creatorcontrib><creatorcontrib>O'Brien, T. S.</creatorcontrib><creatorcontrib>O'Riordan, A.</creatorcontrib><creatorcontrib>Oades, G.</creatorcontrib><creatorcontrib>Okeke, A. A.</creatorcontrib><creatorcontrib>Phillips, S. M. A.</creatorcontrib><creatorcontrib>Ramani, V. A. C.</creatorcontrib><creatorcontrib>Rane, A.</creatorcontrib><creatorcontrib>Ravi, R.</creatorcontrib><creatorcontrib>Ravichandran, S.</creatorcontrib><creatorcontrib>Rimington, P. D.</creatorcontrib><creatorcontrib>Robinson, L. Q.</creatorcontrib><creatorcontrib>Rogers, A. G.</creatorcontrib><creatorcontrib>Sandhu, S.</creatorcontrib><creatorcontrib>Shah, Z.</creatorcontrib><creatorcontrib>Sherwood, B.</creatorcontrib><creatorcontrib>Singh, S.</creatorcontrib><creatorcontrib>Subramonian, K.</creatorcontrib><creatorcontrib>Thilagarajah, R.</creatorcontrib><creatorcontrib>Thomas, B.</creatorcontrib><creatorcontrib>Umez‐Eronini, O. N.</creatorcontrib><creatorcontrib>Varadaraj, H.</creatorcontrib><creatorcontrib>Walton, T.</creatorcontrib><creatorcontrib>Wedderburn, A.</creatorcontrib><creatorcontrib>Weston, R.</creatorcontrib><creatorcontrib>Wills, M. I.</creatorcontrib><creatorcontrib>Yates, D. R.</creatorcontrib><creatorcontrib>British Association of Urological Surgeons (BAUS)</creatorcontrib><creatorcontrib>the British Association of Urological Surgeons ( BAUS )</creatorcontrib><title>Who is at risk of death from nephrectomy? An analysis of thirty‐day mortality after 21 380 nephrectomies in 3 years of the British Association of Urological Surgeons (BAUS) National Nephrectomy Audit</title><title>BJU international</title><addtitle>BJU Int</addtitle><description>Objective
To ascertain contemporary overall and differential thirty‐day mortality (TDM) rates after all types of nephrectomy in the UK, and to identify potential new risk factors for death.
Patients and Methods
We conducted a retrospective analysis of the 110 deaths that occurred within 30 days of surgery out of the total of 21 380 nephrectomies performed, and calculated the odds ratio (OR) and 95% confidence interval (CI) for TDM based on peri‐operative characteristics.
Results
The overall TDM rate was 110/21380 (0.5%). The TDM rates after radical, partial, simple nephrectomy and nephro‐ureterectomy were 0.6% (63/11057), 0.1% (4/3931), 0.4% (11/2819) and 0.9% (28/3091), respectively. TDM increased with age, stage, estimated blood loss (EBL), operating time and performance status. EBL of 1–2 L was associated with a greater risk of TDM than EBL of 2–5 L (OR 1.38; 95% CI 1.03–2.24). Conversion from minimally invasive surgery was associated with higher risk than non‐conversion (OR 2.53; 95% CI 1.14–4.51. Curative surgery was safer than cytoreductive surgery (OR 0.31; 95% CI 0.18–0.54). There was an association between surgical volume and TDM.
Conclusions
This study provides contemporary insights into the true risks of all types of nephrectomy. The TDM rate after nephrectomy in the UK appears acceptably low at 0.5%. Established risk factors were confirmed and the following novel risk factors were identified: modest EBL (1–2 L) and conversion from minimally invasive surgery.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Audit objectives</subject><subject>death</subject><subject>Female</subject><subject>Humans</subject><subject>kidney cancer</subject><subject>Kidney Neoplasms - mortality</subject><subject>Kidney Neoplasms - surgery</subject><subject>Laparoscopy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Minimally invasive surgery</subject><subject>Mortality</subject><subject>national audit</subject><subject>Nephrectomy</subject><subject>Nephrectomy - mortality</subject><subject>Nephrectomy - statistics & numerical data</subject><subject>nephro‐ureterectomy</subject><subject>partial nephrectomy</subject><subject>radical nephrectomy</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>simple nephrectomy</subject><subject>Surgery</subject><issn>1464-4096</issn><issn>1464-410X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10c1u1DAQB3ALgWgpHHgBNBKX9rCtHTtfJ5StKB-qyqGs4BY58bjxksSL7Qjl1kfgtXgNngR3dwsICcuSLfs3f400hDxn9JTFddasp1PGC5E8IIdMZGIhGP388P5Oy-yAPPF-TWl8yNLH5CAphKA05Yfkx6fOgvEgAzjjv4DVoFCGDrSzA4y46Ry2wQ7zK6hGkKPsZx95ZKEzLsw_b78rOcNgXZC9CTNIHdBBwoAX9K96gx7MCBxmlG5fj7B0JhjfQeW9bY0Mxo53Xytne3tjWtnD9eRu0I4ejpfV6voErrYoflz9aQ2qSZnwlDzSsvf4bH8ekdXF64_nbxeXH968O68uFy0vimQhUk3zHPNMUJ5KJShSrjOulM6TXOWUcc64yJlmGmnGGs5STBPZUJ4wppqSH5HjXe7G2a8T-lAPxrfY93JEO_maFWXceVbmkb78h67t5GL3UZVJyUtabtXJTrXOeu9Q1xtnBunmmtH6br51nG-9nW-0L_aJUzOg-i3vBxrB2Q58Mz3O_0-ql-9Xu8hfTqywQw</recordid><startdate>201709</startdate><enddate>201709</enddate><creator>Fernando, Archie</creator><creator>Afzal, N.</creator><creator>Aho, T. 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N.</creator><creator>Varadaraj, H.</creator><creator>Walton, T.</creator><creator>Wedderburn, A.</creator><creator>Weston, R.</creator><creator>Wills, M. I.</creator><creator>Yates, D. R.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7X8</scope></search><sort><creationdate>201709</creationdate><title>Who is at risk of death from nephrectomy? An analysis of thirty‐day mortality after 21 380 nephrectomies in 3 years of the British Association of Urological Surgeons (BAUS) National Nephrectomy Audit</title><author>Fernando, Archie ; Afzal, N. ; Aho, T. F. ; Al‐Akraa, M. ; Al‐Sudani, M. ; Almond, D. J. ; Apakama, I. ; Banerjee, G. K. ; Barber, N. J. ; Biyani, C. S. ; Blacker, A. J. ; Blake, C. ; Boddy, J. ; Bromage, S. J. ; Burgess, N. A. ; Burns‐Cox, N. ; Bycroft, J. ; Calleary, J. G. ; Calvert, R. C. ; Campbell, C. A. ; Cannon, A. ; Cartledge, J. J. ; Chakravarti, A. ; Chen, T. F. ; Choi, W. H. ; Clavijo Eisele, J. ; Cole, O. J. ; Cooksey, G. ; Cornaby, A. J. ; Cornford, P. A. ; Corr, J. G. ; Coulthard, R. ; Crundwell, M. C. ; Davenport, K. ; Dickerson, D. A. G. ; Eddy, B. ; Elsaghir, M. ; Fiala, R. ; Fordham, M. V. P. ; Gall, Z. J. ; Gallegos, C. R. R. ; Garnett, S. ; Ghei, M. ; Gibbons, N. ; Godbole, H. C. ; Golash, A. ; Goodman, C. M. ; Gowardhan, B. ; Gunendran, T. ; Haldar, N. ; Hanbury, D. C. ; Hicks, J. A. ; Hodgson, D. J. ; Ilie, C. ; Johnson, M. I. ; Jones, A. ; Joshi, H. ; Joyce, A. D. ; Kanaga‐Sundaram, S. ; Larner, T. ; Latif, Z. ; Lewis, G. ; Lynn, N. N. K. ; Mackie, S. ; Maddineni, S.B. ; Makar, A. A. ; Manikandan, R. ; Mantle, M. ; McNeill, S. A. ; Mellon, J. K. ; Motiwala, H. G. ; Munro, N. ; Namasivayam, S. ; Nathan, S. ; O'Brien, T. S. ; O'Riordan, A. ; Oades, G. ; Okeke, A. A. ; Phillips, S. M. A. ; Ramani, V. A. C. ; Rane, A. ; Ravi, R. ; Ravichandran, S. ; Rimington, P. D. ; Robinson, L. Q. ; Rogers, A. G. ; Sandhu, S. ; Shah, Z. ; Sherwood, B. ; Singh, S. ; Subramonian, K. ; Thilagarajah, R. ; Thomas, B. ; Umez‐Eronini, O. N. ; Varadaraj, H. ; Walton, T. ; Wedderburn, A. ; Weston, R. ; Wills, M. I. ; Yates, D. R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3882-45f077e764035ad40e03f63ddf727d7013313471f1fe061b315e52ab03211db93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Audit objectives</topic><topic>death</topic><topic>Female</topic><topic>Humans</topic><topic>kidney cancer</topic><topic>Kidney Neoplasms - mortality</topic><topic>Kidney Neoplasms - surgery</topic><topic>Laparoscopy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Minimally invasive surgery</topic><topic>Mortality</topic><topic>national audit</topic><topic>Nephrectomy</topic><topic>Nephrectomy - mortality</topic><topic>Nephrectomy - statistics & numerical data</topic><topic>nephro‐ureterectomy</topic><topic>partial nephrectomy</topic><topic>radical nephrectomy</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>simple nephrectomy</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fernando, Archie</creatorcontrib><creatorcontrib>Afzal, N.</creatorcontrib><creatorcontrib>Aho, T. F.</creatorcontrib><creatorcontrib>Al‐Akraa, M.</creatorcontrib><creatorcontrib>Al‐Sudani, M.</creatorcontrib><creatorcontrib>Almond, D. J.</creatorcontrib><creatorcontrib>Apakama, I.</creatorcontrib><creatorcontrib>Banerjee, G. K.</creatorcontrib><creatorcontrib>Barber, N. J.</creatorcontrib><creatorcontrib>Biyani, C. S.</creatorcontrib><creatorcontrib>Blacker, A. J.</creatorcontrib><creatorcontrib>Blake, C.</creatorcontrib><creatorcontrib>Boddy, J.</creatorcontrib><creatorcontrib>Bromage, S. J.</creatorcontrib><creatorcontrib>Burgess, N. A.</creatorcontrib><creatorcontrib>Burns‐Cox, N.</creatorcontrib><creatorcontrib>Bycroft, J.</creatorcontrib><creatorcontrib>Calleary, J. G.</creatorcontrib><creatorcontrib>Calvert, R. C.</creatorcontrib><creatorcontrib>Campbell, C. A.</creatorcontrib><creatorcontrib>Cannon, A.</creatorcontrib><creatorcontrib>Cartledge, J. J.</creatorcontrib><creatorcontrib>Chakravarti, A.</creatorcontrib><creatorcontrib>Chen, T. F.</creatorcontrib><creatorcontrib>Choi, W. H.</creatorcontrib><creatorcontrib>Clavijo Eisele, J.</creatorcontrib><creatorcontrib>Cole, O. J.</creatorcontrib><creatorcontrib>Cooksey, G.</creatorcontrib><creatorcontrib>Cornaby, A. J.</creatorcontrib><creatorcontrib>Cornford, P. A.</creatorcontrib><creatorcontrib>Corr, J. G.</creatorcontrib><creatorcontrib>Coulthard, R.</creatorcontrib><creatorcontrib>Crundwell, M. C.</creatorcontrib><creatorcontrib>Davenport, K.</creatorcontrib><creatorcontrib>Dickerson, D. A. G.</creatorcontrib><creatorcontrib>Eddy, B.</creatorcontrib><creatorcontrib>Elsaghir, M.</creatorcontrib><creatorcontrib>Fiala, R.</creatorcontrib><creatorcontrib>Fordham, M. V. P.</creatorcontrib><creatorcontrib>Gall, Z. J.</creatorcontrib><creatorcontrib>Gallegos, C. R. R.</creatorcontrib><creatorcontrib>Garnett, S.</creatorcontrib><creatorcontrib>Ghei, M.</creatorcontrib><creatorcontrib>Gibbons, N.</creatorcontrib><creatorcontrib>Godbole, H. C.</creatorcontrib><creatorcontrib>Golash, A.</creatorcontrib><creatorcontrib>Goodman, C. M.</creatorcontrib><creatorcontrib>Gowardhan, B.</creatorcontrib><creatorcontrib>Gunendran, T.</creatorcontrib><creatorcontrib>Haldar, N.</creatorcontrib><creatorcontrib>Hanbury, D. C.</creatorcontrib><creatorcontrib>Hicks, J. A.</creatorcontrib><creatorcontrib>Hodgson, D. J.</creatorcontrib><creatorcontrib>Ilie, C.</creatorcontrib><creatorcontrib>Johnson, M. I.</creatorcontrib><creatorcontrib>Jones, A.</creatorcontrib><creatorcontrib>Joshi, H.</creatorcontrib><creatorcontrib>Joyce, A. D.</creatorcontrib><creatorcontrib>Kanaga‐Sundaram, S.</creatorcontrib><creatorcontrib>Larner, T.</creatorcontrib><creatorcontrib>Latif, Z.</creatorcontrib><creatorcontrib>Lewis, G.</creatorcontrib><creatorcontrib>Lynn, N. N. K.</creatorcontrib><creatorcontrib>Mackie, S.</creatorcontrib><creatorcontrib>Maddineni, S.B.</creatorcontrib><creatorcontrib>Makar, A. A.</creatorcontrib><creatorcontrib>Manikandan, R.</creatorcontrib><creatorcontrib>Mantle, M.</creatorcontrib><creatorcontrib>McNeill, S. A.</creatorcontrib><creatorcontrib>Mellon, J. K.</creatorcontrib><creatorcontrib>Motiwala, H. G.</creatorcontrib><creatorcontrib>Munro, N.</creatorcontrib><creatorcontrib>Namasivayam, S.</creatorcontrib><creatorcontrib>Nathan, S.</creatorcontrib><creatorcontrib>O'Brien, T. S.</creatorcontrib><creatorcontrib>O'Riordan, A.</creatorcontrib><creatorcontrib>Oades, G.</creatorcontrib><creatorcontrib>Okeke, A. A.</creatorcontrib><creatorcontrib>Phillips, S. M. A.</creatorcontrib><creatorcontrib>Ramani, V. A. C.</creatorcontrib><creatorcontrib>Rane, A.</creatorcontrib><creatorcontrib>Ravi, R.</creatorcontrib><creatorcontrib>Ravichandran, S.</creatorcontrib><creatorcontrib>Rimington, P. D.</creatorcontrib><creatorcontrib>Robinson, L. Q.</creatorcontrib><creatorcontrib>Rogers, A. G.</creatorcontrib><creatorcontrib>Sandhu, S.</creatorcontrib><creatorcontrib>Shah, Z.</creatorcontrib><creatorcontrib>Sherwood, B.</creatorcontrib><creatorcontrib>Singh, S.</creatorcontrib><creatorcontrib>Subramonian, K.</creatorcontrib><creatorcontrib>Thilagarajah, R.</creatorcontrib><creatorcontrib>Thomas, B.</creatorcontrib><creatorcontrib>Umez‐Eronini, O. N.</creatorcontrib><creatorcontrib>Varadaraj, H.</creatorcontrib><creatorcontrib>Walton, T.</creatorcontrib><creatorcontrib>Wedderburn, A.</creatorcontrib><creatorcontrib>Weston, R.</creatorcontrib><creatorcontrib>Wills, M. I.</creatorcontrib><creatorcontrib>Yates, D. R.</creatorcontrib><creatorcontrib>British Association of Urological Surgeons (BAUS)</creatorcontrib><creatorcontrib>the British Association of Urological Surgeons ( BAUS )</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>BJU international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fernando, Archie</au><au>Afzal, N.</au><au>Aho, T. F.</au><au>Al‐Akraa, M.</au><au>Al‐Sudani, M.</au><au>Almond, D. J.</au><au>Apakama, I.</au><au>Banerjee, G. K.</au><au>Barber, N. J.</au><au>Biyani, C. S.</au><au>Blacker, A. J.</au><au>Blake, C.</au><au>Boddy, J.</au><au>Bromage, S. J.</au><au>Burgess, N. A.</au><au>Burns‐Cox, N.</au><au>Bycroft, J.</au><au>Calleary, J. G.</au><au>Calvert, R. C.</au><au>Campbell, C. A.</au><au>Cannon, A.</au><au>Cartledge, J. J.</au><au>Chakravarti, A.</au><au>Chen, T. F.</au><au>Choi, W. H.</au><au>Clavijo Eisele, J.</au><au>Cole, O. J.</au><au>Cooksey, G.</au><au>Cornaby, A. J.</au><au>Cornford, P. A.</au><au>Corr, J. G.</au><au>Coulthard, R.</au><au>Crundwell, M. C.</au><au>Davenport, K.</au><au>Dickerson, D. A. G.</au><au>Eddy, B.</au><au>Elsaghir, M.</au><au>Fiala, R.</au><au>Fordham, M. V. P.</au><au>Gall, Z. J.</au><au>Gallegos, C. R. R.</au><au>Garnett, S.</au><au>Ghei, M.</au><au>Gibbons, N.</au><au>Godbole, H. C.</au><au>Golash, A.</au><au>Goodman, C. M.</au><au>Gowardhan, B.</au><au>Gunendran, T.</au><au>Haldar, N.</au><au>Hanbury, D. C.</au><au>Hicks, J. A.</au><au>Hodgson, D. J.</au><au>Ilie, C.</au><au>Johnson, M. I.</au><au>Jones, A.</au><au>Joshi, H.</au><au>Joyce, A. D.</au><au>Kanaga‐Sundaram, S.</au><au>Larner, T.</au><au>Latif, Z.</au><au>Lewis, G.</au><au>Lynn, N. N. K.</au><au>Mackie, S.</au><au>Maddineni, S.B.</au><au>Makar, A. A.</au><au>Manikandan, R.</au><au>Mantle, M.</au><au>McNeill, S. A.</au><au>Mellon, J. K.</au><au>Motiwala, H. G.</au><au>Munro, N.</au><au>Namasivayam, S.</au><au>Nathan, S.</au><au>O'Brien, T. S.</au><au>O'Riordan, A.</au><au>Oades, G.</au><au>Okeke, A. A.</au><au>Phillips, S. M. A.</au><au>Ramani, V. A. C.</au><au>Rane, A.</au><au>Ravi, R.</au><au>Ravichandran, S.</au><au>Rimington, P. D.</au><au>Robinson, L. Q.</au><au>Rogers, A. G.</au><au>Sandhu, S.</au><au>Shah, Z.</au><au>Sherwood, B.</au><au>Singh, S.</au><au>Subramonian, K.</au><au>Thilagarajah, R.</au><au>Thomas, B.</au><au>Umez‐Eronini, O. N.</au><au>Varadaraj, H.</au><au>Walton, T.</au><au>Wedderburn, A.</au><au>Weston, R.</au><au>Wills, M. I.</au><au>Yates, D. R.</au><aucorp>British Association of Urological Surgeons (BAUS)</aucorp><aucorp>the British Association of Urological Surgeons ( BAUS )</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Who is at risk of death from nephrectomy? An analysis of thirty‐day mortality after 21 380 nephrectomies in 3 years of the British Association of Urological Surgeons (BAUS) National Nephrectomy Audit</atitle><jtitle>BJU international</jtitle><addtitle>BJU Int</addtitle><date>2017-09</date><risdate>2017</risdate><volume>120</volume><issue>3</issue><spage>358</spage><epage>364</epage><pages>358-364</pages><issn>1464-4096</issn><eissn>1464-410X</eissn><abstract>Objective
To ascertain contemporary overall and differential thirty‐day mortality (TDM) rates after all types of nephrectomy in the UK, and to identify potential new risk factors for death.
Patients and Methods
We conducted a retrospective analysis of the 110 deaths that occurred within 30 days of surgery out of the total of 21 380 nephrectomies performed, and calculated the odds ratio (OR) and 95% confidence interval (CI) for TDM based on peri‐operative characteristics.
Results
The overall TDM rate was 110/21380 (0.5%). The TDM rates after radical, partial, simple nephrectomy and nephro‐ureterectomy were 0.6% (63/11057), 0.1% (4/3931), 0.4% (11/2819) and 0.9% (28/3091), respectively. TDM increased with age, stage, estimated blood loss (EBL), operating time and performance status. EBL of 1–2 L was associated with a greater risk of TDM than EBL of 2–5 L (OR 1.38; 95% CI 1.03–2.24). Conversion from minimally invasive surgery was associated with higher risk than non‐conversion (OR 2.53; 95% CI 1.14–4.51. Curative surgery was safer than cytoreductive surgery (OR 0.31; 95% CI 0.18–0.54). There was an association between surgical volume and TDM.
Conclusions
This study provides contemporary insights into the true risks of all types of nephrectomy. The TDM rate after nephrectomy in the UK appears acceptably low at 0.5%. Established risk factors were confirmed and the following novel risk factors were identified: modest EBL (1–2 L) and conversion from minimally invasive surgery.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28440053</pmid><doi>10.1111/bju.13842</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1464-4096 |
| ispartof | BJU international, 2017-09, Vol.120 (3), p.358-364 |
| issn | 1464-4096 1464-410X |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged Aged, 80 and over Audit objectives death Female Humans kidney cancer Kidney Neoplasms - mortality Kidney Neoplasms - surgery Laparoscopy Male Middle Aged Minimally invasive surgery Mortality national audit Nephrectomy Nephrectomy - mortality Nephrectomy - statistics & numerical data nephro‐ureterectomy partial nephrectomy radical nephrectomy Retrospective Studies Risk Factors simple nephrectomy Surgery |
| title | Who is at risk of death from nephrectomy? An analysis of thirty‐day mortality after 21 380 nephrectomies in 3 years of the British Association of Urological Surgeons (BAUS) National Nephrectomy Audit |
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