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Background <p>Radical cystectomy (RC) is the gold standard treatment for muscle-invasive bladder cancer (BCa). Chronic liver disease (CLD) may predispose to worse in-hospital outcomes after RC and ileal conduit, but this association has not been investigated. The current study addressed this knowledge gap.</p> Methods <p>Descriptive analyses, propensity score-matching (PSM), and multivariable logistic and Poisson regression models were used to address BCa patients in the National Inpatient Sample treated with RC and ileal conduit (2006–2019).</p> Results <p>Of 15,104 RC and ileal conduit patients, 241 (1.6 %) had CLD at baseline. Compared with their non-CLD counterparts, the CLD patients exhibited significantly higher rates of adverse in-hospital outcomes in 9 of 13 categories, namely, acute kidney injury (AKI, Δ+12.0 %), overall complications (Δ+11.0 %), pulmonary complications (Δ+9.0 %), blood transfusions (Δ+8.0 %), prolonged hospital stay (Δ+7.0 %), infectious complications (Δ+7.0 %), critical care therapies (Δ+4.0 %), in-hospital mortality (Δ+3.6 %), and total hospital charges (THC, Δ+18, 042 US$) (all <i>p</i> &lt; 0.05). After multivariable adjustment, CLD independently predicted higher rates of adverse in-hospital outcomes in the same categories, namely, in-hospital mortality (odds ratio [OR], 2.7; 95 % confidence interval [CI], 1.3–4.9), infectious complications (OR, 2.5; 95 % CI 1.6–3.8), AKI (OR, 2.1; 95 % CI 1.6–2.9), pulmonary complications (OR, 2.0; 95 % CI 1.4–2.8), overall complications (OR, 1.9; 95 % CI 1.7–2.9), critical care therapies (OR, 1.6; 95 % CI 1.2–1.9), blood transfusions (OR, 1.4; 95 % CI 1.1–1.9), prolonged hospital stay (OR, 1.4; 95 % CI 1.1–1.8), and THC (OR, 1.2; 95 % CI 1.1–1.4) (all <i>p</i> &lt; 0.05).</p> Conclusions <p>Although CLD appears to predispose to higher rates of adverse in-hospital outcomes after RC and ileal conduit, it does not increase the rates of these outcomes in a prohibitive fashion.</p>

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The Effect of Chronic Liver Disease on Adverse In-Hospital Outcomes After Radical Cystectomy and Ileal Conduit Urinary Diversion

  • 期刊论文

  • 发表日期：

    2025年8月20日

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  • Federico Polverino,
  • Andrea Marmiroli,
  • Mattia Longoni,
  • Quynh Chi Le,
  • Fabian Falkenbach,
  • Michele Nicolazzini,
  • Calogero Catanzaro,
  • Fred Saad,
  • Jordan A. Goyal,
  • Simone Morra,
  • Gianluigi Califano,
  • Roberto La Rocca,
  • Claudia Collà Ruvolo,
  • Alberto Briganti,
  • Felix K. H. Chun,
  • Markus Graefen,
  • Carlotta Palumbo,
  • Riccardo Schiavina,
  • Gennaro Musi,
  • Shahrokh F. Shariat,
  • Nicola Longo,
  • Pierre I. Karakiewicz

摘要

Background

Radical cystectomy (RC) is the gold standard treatment for muscle-invasive bladder cancer (BCa). Chronic liver disease (CLD) may predispose to worse in-hospital outcomes after RC and ileal conduit, but this association has not been investigated. The current study addressed this knowledge gap.

Methods

Descriptive analyses, propensity score-matching (PSM), and multivariable logistic and Poisson regression models were used to address BCa patients in the National Inpatient Sample treated with RC and ileal conduit (2006–2019).

Results

Of 15,104 RC and ileal conduit patients, 241 (1.6 %) had CLD at baseline. Compared with their non-CLD counterparts, the CLD patients exhibited significantly higher rates of adverse in-hospital outcomes in 9 of 13 categories, namely, acute kidney injury (AKI, Δ+12.0 %), overall complications (Δ+11.0 %), pulmonary complications (Δ+9.0 %), blood transfusions (Δ+8.0 %), prolonged hospital stay (Δ+7.0 %), infectious complications (Δ+7.0 %), critical care therapies (Δ+4.0 %), in-hospital mortality (Δ+3.6 %), and total hospital charges (THC, Δ+18, 042 US$) (all p < 0.05). After multivariable adjustment, CLD independently predicted higher rates of adverse in-hospital outcomes in the same categories, namely, in-hospital mortality (odds ratio [OR], 2.7; 95 % confidence interval [CI], 1.3–4.9), infectious complications (OR, 2.5; 95 % CI 1.6–3.8), AKI (OR, 2.1; 95 % CI 1.6–2.9), pulmonary complications (OR, 2.0; 95 % CI 1.4–2.8), overall complications (OR, 1.9; 95 % CI 1.7–2.9), critical care therapies (OR, 1.6; 95 % CI 1.2–1.9), blood transfusions (OR, 1.4; 95 % CI 1.1–1.9), prolonged hospital stay (OR, 1.4; 95 % CI 1.1–1.8), and THC (OR, 1.2; 95 % CI 1.1–1.4) (all p < 0.05).

Conclusions

Although CLD appears to predispose to higher rates of adverse in-hospital outcomes after RC and ileal conduit, it does not increase the rates of these outcomes in a prohibitive fashion.