To test the effect of obesity (body mass index [BMI] ≥30 kg/m2) on perioperative outcomes and total hospital charges (THC) at robot-assisted vs. open radical prostatectomy (RARP vs. ORP).
Within the National Inpatient Sample database (2008-2015), we identified obese vs. non-obese RARP and ORP patients. Estimated annual percent changes, multivariable logistic regression (MLR) and linear regression models were used. All models were adjusted for clustering and weighted.
Of all, 53,626 (60%) underwent RARP vs. 35,757 (40%) underwent ORP. At RARP, 8.6% were obese vs. 6.9% at ORP. RARP rate increased significantly over time (12.5-81.5%). Obesity rate increased significantly over time at both, RARP (5.1-10.5%) and ORP (5.4-10.7%). In MLR models, obesity predicted five of eleven unfavourable perioperative complications at RARP (Odds ratio [OR]: 1.6-1.8) and nine of eleven at ORP (OR: 1.3-2.8). In linear regression models, obesity significantly added to THC at RARP (740$) and ORP (312$).
Obesity may predispose to higher rates of adverse outcomes at RP. Its effect varies according to surgical approach.
Urology. 2019 Jul 20 [Epub ahead of print]
Sophie Knipper, Elio Mazzone, Francesco A Mistretta, Carlotta Palumbo, Zhe Tian, Alberto Briganti, Fred Saad, Derya Tilki, Markus Graefen, Pierre I Karakiewicz
Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada. Electronic address: ., Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy., Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, European Institute of Oncology, Milan, Italy., Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, Spedali Civili Hospital, University of Brescia, Brescia, Italy., Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada., Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy., Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Division of Urology, University of Montréal Hospital Center, Montréal, Québec, Canada., Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany., Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.