The Effect of Valvulopathy on Adverse In-Hospital Outcomes After Partial and Radical Nephrectomy.

BACKGROUND

The effect of valvulopathy on adverse in-hospital outcomes after partial nephrectomy (PN) and radical nephrectomy (RN) is unknown.

PATIENTS AND METHODS

Descriptive analyses, 1:2 propensity score matching and multivariable logistic and Poisson regression models were used to address National Inpatient Sample (2000-2019) patients with kidney cancer who underwent PN and RN, stratified according to presence or absence of valvulopathy.

RESULTS

Overall, 38,673 patients underwent PN versus 92,072 RN. Of those, 836 (2.2%) and 2651 (2.9%) had valvulopathy, respectively. Valvulopathy rate decreased from 3.04 to 1.57% in PN patients (2000-2019, EAPC: -1.74%, p = 0.02), and from 2.97 to 2.28% in RN patients (2000-2019, EAPC: -0.94%, p = 0.01). RN patients with valvulopathy were older and carried a higher number of comorbidities than PN patients with valvulopathy. Valvulopathy in PN patients independently predicted higher rates of adverse in-hospital outcomes in 7 of 14 examined categories, with odds ratio (OR) ranging from 2.96 for cardiac complications to 2.35 for vascular complications and 1.78 for bleeding complications (all p < 0.05), but not in-hospital mortality (p > 0.05). Valvulopathy in RN patients independently predicted higher rates of adverse in-hospital outcomes in 9 of 14 examined categories, with OR ranging from 2.88 for cardiac complications to 1.83 for vascular complications and 1.43 for overall complications (all p < 0.05), but not in-hospital mortality (p > 0.05).

CONCLUSIONS

Patients with valvulopathy treated with RN are generally older and present with more baseline comorbidities. In this population, RN is associated with a higher risk of adverse in-hospital outcomes compared with PN when examining the impact of valvulopathy on such outcomes.