Early Post-RP Complications Directly Related to Age

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Older patients should be informed about potentially higher complication rates associated with  postoperative radical prostatectomy.
Older patients should be informed about potentially higher complication rates associated with postoperative radical prostatectomy.

Virtually all early postoperative radical prostatectomy (RP) complications are directly related to patient age, investigators concluded based on a recent retrospective study. The influence of age on postoperative complications is especially pronounced among patients aged 70 years or older.

As a result of study findings, older patients should be informed about potentially higher complication rates, according to investigators. “Similarly, older patients may require longer hospital stay, even though the absolute increase in individual patients may be marginal at best,” the authors wrote in European Urology Focus.

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The study found that each 1-year increase in age at the time of surgery independently predicted significant 2% increased odds of complications overall and 3%, 3%, and 2% increased odds of intraoperative, cardiac, and pulmonary complications, respectively, after adjusting for multiple variables, Felix Preisser, MD, of University Hospital Frankfurt in Germany, and colleagues reported. Increasing age also was associated with longer hospital stays.

Further, compared with patients younger than 70 years, those aged 70 years and older had significant 26% increased odds of overall complications, 43% increased odds of intraoperative complications, and 40%, 25%, 27%, and 27% increased odds of genitourinary, miscellaneous surgical, miscellaneous medical, and vascular complications, respectively.

For the study, Dr Preisser's team used the National Inpatient Sample database to identify 68,780 patients with prostate cancer (PCa) who underwent robotic-assisted or open RP from 2008 to 2013. Patients had a median age of 62 years. The database includes 20% of US inpatient hospitalizations, with discharge abstracts from 8 million hospital stays, the authors noted. In the study cohort as a whole, 57.3% underwent robotic-assisted RP (RARP). Overall complications developed in 12.4% of patients.

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