Scholarlink

Study design <p>Observational cohort study.</p> Objective <p>To test for the association between paraplegia and adverse in-hospital outcomes after major cancer surgery.</p> Methods <p>Within National Inpatient Sample (2000–2019), we identified adult patients who underwent colectomy, radical hysterectomy, lung resection, gastrectomy and pancreatectomy for a primary cancer diagnosis. Descriptive analyses, propensity score matching (PSM, ratio 1:10) and multivariable logistic regression models (LRMs) were fitted.</p> Setting <p>US.</p> Results <p>We identified 957 (0.3%) paraplegics at colectomy, 250 (0.2%) at radical hysterectomy, 138 (0.3%) at lung resection, 94 (0.3%) at gastrectomy and 75 (0.2%) at pancreatectomy. After PSM and additional multivariable adjustment for patients, surgical and hospital characteristics, paraplegia independently predicted 12 of 12 examined endpoints after colectomy and radical hysterectomy, 11 of 12 after lung resection, 9 of 12 after pancreatectomy and 4 of 12 after gastrectomy. Across the examined surgeries, the magnitude of the increase in adverse in-hospital outcomes ranged from 2.4–3.7-fold for overall complications, 2.4–2.9-fold for intraoperative complications, 2.7–4.8-fold for vascular complications and 1.5–2.3-fold for length of stay ≥75<sup>th</sup>-percentile. Paraplegics also exhibited a 3.8–6.3-fold higher rate of in-hospital mortality after colectomy, lung resection and pancreatectomy, but not after gastrectomy and radical hysterectomy.</p> Conclusion <p>Across the five major oncologic procedures, paraplegic patients consistently exhibited higher rates of adverse in-hospital outcomes. The excess risk was most pronounced after colectomy, radical hysterectomy, and lung resection, moderate after pancreatectomy, and least evident after gastrectomy. Similarly, the magnitude of the disadvantage also varied depending on the definition of adverse in-hospital outcome and major cancer surgery type.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Adverse in-hospital outcomes after major cancer surgery in paraplegic patients

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月16日

查看全文
  • Andrea Marmiroli,
  • Natali Rodriguez Peñaranda,
  • Mattia Longoni,
  • Quynh Chi Le,
  • Fabian Falkenbach,
  • Michele Nicolazzini,
  • Calogero Catanzaro,
  • Jordan A. Goyal,
  • Stefano Luzzago,
  • Francesco Alessandro Mistretta,
  • Mattia Piccinelli,
  • Fred Saad,
  • Shahrokh F. Shariat,
  • Alberto Briganti,
  • Felix K. H. Chun,
  • Salvatore Micali,
  • Markus Graefen,
  • Carlotta Palumbo,
  • Riccardo Schiavina,
  • Gennaro Musi,
  • Pierre I. Karakiewicz

摘要

Study design

Observational cohort study.

Objective

To test for the association between paraplegia and adverse in-hospital outcomes after major cancer surgery.

Methods

Within National Inpatient Sample (2000–2019), we identified adult patients who underwent colectomy, radical hysterectomy, lung resection, gastrectomy and pancreatectomy for a primary cancer diagnosis. Descriptive analyses, propensity score matching (PSM, ratio 1:10) and multivariable logistic regression models (LRMs) were fitted.

Setting

US.

Results

We identified 957 (0.3%) paraplegics at colectomy, 250 (0.2%) at radical hysterectomy, 138 (0.3%) at lung resection, 94 (0.3%) at gastrectomy and 75 (0.2%) at pancreatectomy. After PSM and additional multivariable adjustment for patients, surgical and hospital characteristics, paraplegia independently predicted 12 of 12 examined endpoints after colectomy and radical hysterectomy, 11 of 12 after lung resection, 9 of 12 after pancreatectomy and 4 of 12 after gastrectomy. Across the examined surgeries, the magnitude of the increase in adverse in-hospital outcomes ranged from 2.4–3.7-fold for overall complications, 2.4–2.9-fold for intraoperative complications, 2.7–4.8-fold for vascular complications and 1.5–2.3-fold for length of stay ≥75th-percentile. Paraplegics also exhibited a 3.8–6.3-fold higher rate of in-hospital mortality after colectomy, lung resection and pancreatectomy, but not after gastrectomy and radical hysterectomy.

Conclusion

Across the five major oncologic procedures, paraplegic patients consistently exhibited higher rates of adverse in-hospital outcomes. The excess risk was most pronounced after colectomy, radical hysterectomy, and lung resection, moderate after pancreatectomy, and least evident after gastrectomy. Similarly, the magnitude of the disadvantage also varied depending on the definition of adverse in-hospital outcome and major cancer surgery type.