Clinical characteristics and outcomes of robot-assisted laparoscopic radical prostatectomy in HIV-positive patients: a nationwide population-based analysisShow others and affiliations
2019 (English)In: International Urology and Nephrology, ISSN 0301-1623, E-ISSN 1573-2584Article in journal (Refereed) Published
Abstract [en]
Purpose: To compare differences in clinical characteristics and outcomes between patients with and without human immunodeficiency virus (HIV) infection in light of robot-assisted laparoscopic radical prostatectomy (RALRP) as the most common surgical technique for prostate cancer. Previous data on perioperative complication rates of RALRP in HIV(+) patients are limited by small sample size.
Methods: The National Inpatient Sample database from 2008 to 2014 was used to query prostate cancer patients who underwent RALRP. HIV(+) patients were identified through ICD9 codes 042, 043, 044, V08 and 079.53. Intraoperative and postoperative complications, rate of blood transfusion, in-hospital mortality, prolonged length of stay and total cost were compared by univariate, multivariate regression and 1:4 propensity score matched analyses.
Results: Overall, 270,319 weighted patients undergoing RALRP were identified, among whom 546 (0.20%) patients were diagnosed with HIV. Patients with HIV were younger, less likely to be white and had more comorbidities. Multivariable regression analysis revealed that HIV(+) patients had significantly increased genitourinary complications (odds ratio [OR]: 3.31; 95% confidence interval [CI]: 1.03-10.68) and miscellaneous surgical events (OR 3.19; 95% CI 1.26-8.08). There were no differences in potentially life-threatening cardiac, respiratory and vascular events between patients with and without HIV after RALRP. Propensity score matched analysis yielded similar results.
Conclusions: Our findings suggest that patients who underwent RALRP with HIV did not experience higher risk of potentially life-threatening postoperative complications. RALRP could be safely considered as a surgical treatment for HIV(+) patients with prostate cancer.
Place, publisher, year, edition, pages
Springer, 2019.
Keywords [en]
Robotic surgery, Radical prostatectomy, HIV, Complications, Propensity score
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:oru:diva-77900DOI: 10.1007/s11255-019-02321-zISI: 000493669000002PubMedID: 31679137Scopus ID: 2-s2.0-85074709604OAI: oai:DiVA.org:oru-77900DiVA, id: diva2:1370469
Note
Funding Agencies:
National key research and development program of China 2017YFC0908005
Fourth Round of Shanghai Three-year Action Plan on Public Health Discipline and Talent Program: Evidence-based Public Health and Health Economics 15GWZK0901
2019-11-152019-11-152023-12-08Bibliographically approved