ArticleAnnals of surgical oncology2025
Perioperative Complications and In-Hospital Mortality in Radical Nephroureterectomy Patients with Heart Valve Replacement.
Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Type 2 Diabetes Mellitus and Adverse In-Hospital Outcomes after Nephroureterectomy.Urologia internationalis · 2026Article
- Non-Caucasian Race/Ethnicity Predisposes to Unfavorable Stage and Grade at Upper Tract Urothelial Carcinoma Diagnosis.Journal of racial and ethnic health disparities · 2026Article
- Robotic vs. open partial cytoreductive nephrectomy in metastatic renal cell carcinoma: adverse in-hospital outcomes.World journal of urology · 2025Article
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16 authors.
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Abstract
backgroundPerioperative complication rates and in-hospital mortality after radical nephroureterectomy (RNU) in patients with a history of heart valve replacement are unknown.
methodsWithin the National Inpatient Sample (2000-2019), we identified non-metastatic upper urinary tract carcinoma patients treated with RNU according to the presence or absence of a history of heart valve replacement. Propensity score matching (1:10 ratio) and multivariable logistic regression as well as Poisson regression models were used.
resultsOf 15,423 RNU patients, 151 (1.0%) harbored heart valve replacement. This proportion increased over the study span from 0.5% to 1.4% (p = 0.02). Heart valve replacement patients were older (median 78 vs. 72 years; p < 0.001), more frequently male (73 vs. 60%; p = 0.002), and more frequently harbored a Charlson Comorbidity Index (CCI) ≥3 (36 vs. 27%; p = 0.002). After 1:10 propensity score matching for age, sex, and CCI, the patients exhibited higher rates of perioperative bleeding (7.4 vs. 2.4%; odds ratio [OR] 3.2; p < 0.001), blood transfusions (24.0 vs. 17.0%; OR 1.6; p = 0.02), and cardiac complications (24.0 vs. 14.0%; OR 2.1; p < 0.001). Conversely, heart valve replacement patients did not exhibit higher rates of critical care therapy (OR 1.06; p = 0.8), higher rates of in-hospital mortality (OR 0.8; p = 0.8), and longer length of stay (OR 1.4; p = 0.052) than their RNU counterparts without a history of heart valve replacement.
conclusionRNU patients with a history of heart valve replacement are at significantly increased risk of perioperative bleeding, blood transfusions, and cardiac complications; however, despite these increased risks, they neither exhibited higher critical care therapy rates or higher in-hospital mortality rates, nor did they require significantly longer hospital stay.
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