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dc.contributor.authorHollenbeck, Brent K.en_US
dc.contributor.authorMiller, David C.en_US
dc.contributor.authorTaub, Daviden_US
dc.contributor.authorDunn, Rodney L.en_US
dc.contributor.authorKhuri, Shukri F.en_US
dc.contributor.authorHenderson, William G.en_US
dc.contributor.authorMontie, James E.en_US
dc.contributor.authorUnderwood, Willieen_US
dc.contributor.authorWei, John T.en_US
dc.date.accessioned2007-01-17T15:54:06Z
dc.date.available2007-01-17T15:54:06Z
dc.date.issued2006en_US
dc.identifier.citationHollenbeck, Brent K.; Miller, David C.; Taub, David; Dunn, Rodney L.; Khuri, Shukri F.; Henderson, William G.; Montie, James E.; Underwood, Willie; Wei, John T. (2006)."Risk factors for adverse outcomes after transurethral resection of bladder tumors." Cancer 9999(9999): NA-NA. <http://hdl.handle.net/2027.42/49292>en_US
dc.identifier.issn0008-543Xen_US
dc.identifier.issn1097-0142en_US
dc.identifier.urihttps://hdl.handle.net/2027.42/49292
dc.description.abstractBACKGROUND Risk factors for adverse outcomes after transurethral resection of bladder tumors (TURBT) have not been identified to date. Such information would facilitate preoperative risk stratification and case-mix–adjusted outcome comparison, and lead to the development of processes of care directed at improving outcomes and ultimately the quality of care for bladder carcinoma patients. METHODS The National Surgical Quality Improvement Program (NSQIP) is a prospective quality management initiative of 123 Veterans Affairs Medical Centers nationwide. Since 1991, a total of 21,515 TURBTs have been prospectively registered by the NSQIP; these cases compose the current study population. Using multivariable logistic regression, the authors determined the independent association between preoperative patient risk factors and perioperative elements of structure/process and morbidity, mortality, and prolonged length of stay (LOS) outcomes. RESULTS The postoperative complication, 30-day, and 90-day mortality rates were 4.3%, 1.3%, and 3.3%, respectively. The median, 75th percentile, and 90th percentile for LOS among patients undergoing TURBT was 2 days, 3 days, and 8 days, respectively. Robust preoperative patient risk factors that were found to be uniformly associated with all adverse outcomes included the presence of disseminated disease (odds ratio [OR], 1.9-5.2) weight loss (OR, 1.8-3.8), low serum albumin (OR, 2.3-7.1), elevated serum creatinine (OR, 1.3-2.9), a dependent functional status (OR, 1.5-2.7), and emergent case status (OR, 1.8-3.1). Compared with models using preoperative patient factors alone, models including perioperative structure and process measures explained further variation in surgical outcomes (each likelihood ratio test, P < .0001). CONCLUSIONS The findings of the current study highlight the fact that there are a wide array of patient risk factors that are associated with adverse outcomes after TURBT. Validation of those processes implemented to modify such elements can provide a basis for quality metrics in the context of TURBT. Cancer 2006. © 2006 American Cancer Society.en_US
dc.format.extent180449 bytes
dc.format.extent3118 bytes
dc.format.mimetypeapplication/pdf
dc.format.mimetypetext/plain
dc.language.isoen_US
dc.publisherWiley Subscription Services, Inc., A Wiley Companyen_US
dc.subject.otherLife and Medical Sciencesen_US
dc.subject.otherCancer Research, Oncology and Pathologyen_US
dc.titleRisk factors for adverse outcomes after transurethral resection of bladder tumorsen_US
dc.typeArticleen_US
dc.rights.robotsIndexNoFollowen_US
dc.subject.hlbsecondlevelOncology and Hematologyen_US
dc.subject.hlbsecondlevelPublic Healthen_US
dc.subject.hlbtoplevelHealth Sciencesen_US
dc.description.peerreviewedPeer Revieweden_US
dc.contributor.affiliationumDepartment of Urology, The University of Michigan, Ann Arbor, Michigan ; Fax: (734) 936-9127 ; Department of Urology, University of Michigan, 1500 E. Medical Center Dr., TC 3875-0330, Ann Arbor, MI 48109-0330en_US
dc.contributor.affiliationumDepartment of Urology, The University of Michigan, Ann Arbor, Michiganen_US
dc.contributor.affiliationumDepartment of Urology, The University of Michigan, Ann Arbor, Michiganen_US
dc.contributor.affiliationumDepartment of Urology, The University of Michigan, Ann Arbor, Michiganen_US
dc.contributor.affiliationumDepartment of Urology, The University of Michigan, Ann Arbor, Michiganen_US
dc.contributor.affiliationumDepartment of Urology, The University of Michigan, Ann Arbor, Michigan ; Veterans Affairs Medical Center, Ann Arbor, Michiganen_US
dc.contributor.affiliationumDepartment of Urology, The University of Michigan, Ann Arbor, Michiganen_US
dc.contributor.affiliationotherNational Surgical Quality Improvement Program, West Roxbury, Massachusettsen_US
dc.contributor.affiliationotherNational Surgical Quality Improvement Program, West Roxbury, Massachusettsen_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/49292/1/20436_ftp.pdfen_US
dc.identifier.doihttp://dx.doi.org/10.1002/cncr.21765en_US
dc.identifier.sourceCanceren_US
dc.owningcollnameInterdisciplinary and Peer-Reviewed


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