Inflammatory bowel disease vs. adverse in-hospital outcomes after radical prostatectomy.
Academic Article
Overview
abstract
INTRODUCTION: The effect of inflammatory bowel disease (IBD) on adverse in-hospital outcomes after radical prostatectomy (RP) for nonmetastatic prostate cancer (PCa) is not well known. MATERIALS AND METHODS: Descriptive analyses, propensity score matching and multivariable logistic regression models were used within the National Inpatient Sample (2000-2019) RP patients, after stratification according to Crohn's disease (CD) vs. ulcerative colitis (UC) vs. no-IBD, and RP type (minimally invasive [MIRP] vs. open [ORP]). RESULTS: Of 251,334 RP patients, 486 (0.2%) had CD vs. 446 (0.2%) UC. In CD patients vs. no-IBD counterparts, MIRP (n = 223) independently predicted higher rates of adverse in-hospital outcomes in 3/15 categories, including overall (OR:1.64, P < 0.01) and postoperative (OR:1.73, P < 0.01) complications. Conversely, in CD patients vs. no-IBD counterparts, ORP (n = 263) independently predicted higher rates of adverse in-hospital outcomes in 5/15 categories, including also overall (OR:1.37, P < 0.05), and postoperative (OR:1.44, P < 0.05) complications. In UC patients vs. no-IBD counterparts, MIRP (n = 218) independently predicted higher rates of adverse in-hospital outcomes in only 1/15 categories, namely prolonged length of stay (OR:1.64, P < 0.001). Conversely, in UC patients vs. no-IBD counterparts, ORP (n = 228) independently predicted higher rates of adverse in-hospital outcomes in 3/15 categories, including overall (OR:1.49, P < 0.05) and intraoperative (OR:2.31, P < 0.01) complications. CONCLUSION: In the current analysis, direct comparisons with no-IBD patients showed worse in-hospital outcomes for both CD and UC patients, with adverse in-hospital outcomes indirectly appearing more severe in CD than in UC patients. In both subgroups, MIRP was associated with fewer adverse outcomes than ORP, based on comparison with no-IBD patients.
