Abstract
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.
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Article info
Publication history
Published online: May 21, 2021
Accepted:
May 13,
2021
Received:
January 24,
2021
Footnotes
Financial Disclosure: The authors have no financial conflicts to disclose.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
