Temporal Trends in Conduit Urinary Diversion With Concomitant Cystectomy for Benign Indications: A Population-based Analysis - 19/04/17
, David Osborn a, Stephen Mock a, Shenghua Ni b, Amy J. Graves a, Laurel Milam a, Douglas Milam a, Melissa R. Kaufman a, Roger R. Dmochowski a, W. Stuart Reynolds aAbstract |
Objective |
To describe national trends in cystectomy at the time of urinary diversion for benign indications. Multiple practice patterns exist regarding the necessity for concomitant cystectomy with urinary diversion for benign end-stage lower urinary tract dysfunction. Beyond single-institution reports, limited data are available to describe how concurrent cystectomy is employed on a national level.
Materials and Methods |
A representative sample of patients undergoing urinary diversion for benign indications with or without concurrent cystectomy was identified from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from 1998 to 2011. Using multivariate logistic regression models, we identified hospital- and patient-level characteristics associated with concomitant cystectomy with urinary diversion.
Results |
There was an increase in the proportion of concomitant cystectomy at the time of urinary diversion from 20% to 35% (P < .001) between 1998 and 2011. The increase in simultaneous cystectomy over time occurred at teaching hospitals (vs community hospitals), in older patients, in male patients, in the Medicare population (vs private insurance and Medicaid), and in those with certain diagnoses.
Conclusion |
There has been an overall increase in the use of cystectomy at the time of urinary diversion for benign indications on a national level, although the indications driving this clinical decision appear inconsistent.
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| Financial Disclosure: Roger R. Dmochowski is a paid consultant for Allergan and Medtronic. Melissa R. Kaufman is a paid consultant for Cook Myosite and Boston Scientific. Douglas Milam is a paid consultant for Boston Scientific. The remaining authors declare that they have no relevant financial interests. |
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| Funding Support: This study was supported by CTSA award No. UL1TR000445 from the National Center for Advancing Translational Sciences, the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under award number K23DK103910, and by the Vanderbilt Office of Clinical and Translational Scientist Development (VICTR # 10271). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of Vanderbilt University, the National Center for Advancing Translational Sciences, or the National Institutes of Health. |
Vol 98
P. 70-74 - décembre 2016 Retour au numéro
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