Clinical Factors Associated with Major Adverse Cardiac Events after Bladder Cancer Surgery

What is it about?

This study investigated the association between major adverse cardiac events (MACE) and clinical factors of patients undergoing radical cystectomy (RC) for bladder cancer. A retrospective analysis using the 2015-2020 National Surgical Quality Improvement Program database was performed on 10,308 patients who underwent RC with incontinent urinary diversion (iUD) and 1,938 patients who underwent RC with continent urinary diversion (cUD). MACE was defined as any report of cerebrovascular accident, myocardial infarction, or thromboembolic events (pulmonary embolism or deep vein thrombosis). A multivariable-adjusted logistic regression was conducted to identify clinical predictors of postoperative MACE. The study found that MACE was significantly associated with increased age, obesity, smoking, congestive heart failure, and hypertension. Thromboembolic events were the most common type of MACE, followed by MI and CVA. The study suggests that urologists may be able to avoid the increased risk of MACE by performing RC with iUD for patients in whom RC may be technically more challenging and limiting RC with cUD to high-volume centres with extensive expertise. [Some of the content on this page has been created by AI]

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Why is it important?

This research is important as it investigates the association between major adverse cardiac events (MACE) and clinical factors of patients undergoing radical cystectomy (RC) for bladder cancer. The study provides valuable insights into the risk factors for postoperative MACE, which can help surgeons evaluate the pre-operative characteristics of patients and select the most appropriate urinary diversion approach to decrease the incidence of MACE. Key Takeaways: 1. The study found that MACE was significantly associated with increased age, obesity, smoking, congestive heart failure, and hypertension. 2. Thromboembolic events were the most common type of MACE, followed by MI and CVA. 3. surgical and anatomic constraints that require extended operative time may increase the risk of thromboembolic events and overall MACE. 4. Urologists may be able to avoid the increased risk of MACE by performing RC with iUD for patients in whom RC may be technically more challenging (i.e., prior abdominal surgeries, obesity, and narrow pelvis) and require longer operative time. 5. Limiting RC with cUD to high-volume centres with extensive expertise may help to keep operative times low and limit the risk of overall MACE.