TY - JOUR
T1 - The Impact of Race and Gender on 30-Day Urologic Surgery Complications
AU - Chertack, Nathan
AU - Baky, Fady
AU - Samplaski, Mary K.
AU - Vij, Sarah C.
AU - Bakare, Tolulope
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/4
Y1 - 2022/4
N2 - Objective: To assess the effect of race and gender on complications after urologic surgeries. Materials and Methods: The American College of Surgeons’ National Surgical Quality Improvement Program data was utilized for patients undergoing urologic surgeries. Patient demographics and comorbidities were analyzed. Postoperative complications occurring in a 30-day postoperative period were noted and classified per the Clavien-Dindo classification. Results: From 2008-2018, 284,050 patients underwent urologic surgery. The majority were men (80%) and identified as non-Hispanic white (80%). Complications occurred in 12%, including 9% minor, 5% major, and mortality in 0.6%. Univariate analysis found female gender, non-Hispanic black and Native American race, and patient comorbidities (hypertension, diabetes, heart failure, lung disease, chronic kidney disease) to be associated with increased risk of complications. Female gender remained a significant predictor on multivariable logistic regression, and Hispanic race was found to be an independent negative predictor of postoperative complications, although these results did not appear clinically significant. On exclusion of gender-specific urologic surgeries, female gender was associated with higher likelihood of minor complications, but male gender was associated with higher likelihood of major complications or mortality. Conclusion: Race was not associated with postoperative complication rate. Patient comorbidities are associated with an increased risk of 30-day postoperative complications. Females were more likely to have minor and males were more likely to major complications. Optimizing patient comorbidities preoperatively is key to improving postoperative outcomes.
AB - Objective: To assess the effect of race and gender on complications after urologic surgeries. Materials and Methods: The American College of Surgeons’ National Surgical Quality Improvement Program data was utilized for patients undergoing urologic surgeries. Patient demographics and comorbidities were analyzed. Postoperative complications occurring in a 30-day postoperative period were noted and classified per the Clavien-Dindo classification. Results: From 2008-2018, 284,050 patients underwent urologic surgery. The majority were men (80%) and identified as non-Hispanic white (80%). Complications occurred in 12%, including 9% minor, 5% major, and mortality in 0.6%. Univariate analysis found female gender, non-Hispanic black and Native American race, and patient comorbidities (hypertension, diabetes, heart failure, lung disease, chronic kidney disease) to be associated with increased risk of complications. Female gender remained a significant predictor on multivariable logistic regression, and Hispanic race was found to be an independent negative predictor of postoperative complications, although these results did not appear clinically significant. On exclusion of gender-specific urologic surgeries, female gender was associated with higher likelihood of minor complications, but male gender was associated with higher likelihood of major complications or mortality. Conclusion: Race was not associated with postoperative complication rate. Patient comorbidities are associated with an increased risk of 30-day postoperative complications. Females were more likely to have minor and males were more likely to major complications. Optimizing patient comorbidities preoperatively is key to improving postoperative outcomes.
UR - http://www.scopus.com/inward/record.url?scp=85108957725&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85108957725&partnerID=8YFLogxK
U2 - 10.1016/j.urology.2021.05.023
DO - 10.1016/j.urology.2021.05.023
M3 - Article
C2 - 34029606
AN - SCOPUS:85108957725
SN - 0090-4295
VL - 162
SP - 77
EP - 83
JO - Urology
JF - Urology
ER -