The study objective was to assess the 30 day infection risk for patients after radical cystectomy. The authors collected data on 3187 patients from the ACS-NSQUIP database from 2005-2013. 766 patients (24%) developed an infection within 30 days. Median hospital stay was 8 days and median time to infection was 13 days. UTIs occurred in 10% of patients, surgical site infections in 12.7% and sepsis in 12.7%.
On multivariable analysis BMI, blood transfusion, and operative time greater than eight hours were significant risk factors for post-operative infection. UTIs were associated with age less than 50, obesity, non-smoking status, and operative time greater than eight hours. Surgical site infections were associated with age less than 50, obesity, blood transfusion, and operative time greater than six hours. Finally, sepsis was associated with obesity, blood transfusion, and operative time greater than eight hours.
The author highlighted that modifiable factors to reduce post-cystectomy infections were decreasing operative time and reducing blood transfusions. Additionally, the majority of infections occurred after hospital discharge, suggesting that patients with risk factors could benefit from post-discharge monitoring.
Presented by William Parker (Mayo Clinic) American Urological Association (AUA) Annual Meeting May 6-10, 2016 San Diego, CA
Reported by Lisa Parrillo (University of Pennsylvania) American Urological Association (AUA) Annual Meeting May 6-10, 2016 San Diego, CA