Preoperative risk factors related to bladder cancer rehabilitation: a registry study
Introduction: Patients diagnosed with (muscle-) invasive bladder cancer (IBC) are more likely to harbour comorbidities due to their advanced age at diagnosis. Under-nutrition is a predictor for postoperative morbidity and mortality in cancer patients, but under-reported in urology. Understanding the...
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| Published in | European journal of clinical nutrition Vol. 67; no. 9; pp. 917 - 921 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
London
Nature Publishing Group UK
01.09.2013
Nature Publishing Group |
| Subjects | |
| Online Access | Get full text |
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| Abstract | Introduction:
Patients diagnosed with (muscle-) invasive bladder cancer (IBC) are more likely to harbour comorbidities due to their advanced age at diagnosis. Under-nutrition is a predictor for postoperative morbidity and mortality in cancer patients, but under-reported in urology. Understanding the IBC patient profile before major surgery could facilitate and optimise outcome of the surgical patient.
Background/objectives:
To identify preoperative risk factors for early rehabilitation before radical cystectomy (RC).
Subjects/methods:
A historical registry-based study of 76 patients referred for RC at Aarhus University Hospital, Denmark (DK) in 2009. Early rehabilitation was defined by length of stay (LOS) postoperatively with a cutoff ⩽11 days. High comorbidity was expressed by the charlson comorbidity index score (CCI) ⩾3. LOS was calculated by linking the unique Civil Registration Number with the National Patient Registry. Preoperative nutritional risk was identified using the screening tool, nutritional risk score 2002 (NRS) of the European Society of Clinical Nutrition and Metabolism. Multivariate analysis was used to identify risk factors for early rehabilitation.
Results:
The proportion of patients at preoperative nutritional risk was 26% (95% confidence interval (CI): (95% CI: 17; 37) and 43% of patients held a high CCI (95% CI: 33; 55). Prolonged LOS was independently associated with female gender (
P
=0.02) and age ⩾70 years (
P
=0.04). NRS and CCI were not associated with LOS.
Conclusions:
Attention should be focused on women and elderly patients undergoing RC to optimise early rehabilitation and reduce LOS. It is still unknown whether preoperative nutritional risk and comorbidity are obstacles in early rehabilitation of RC patients. |
|---|---|
| AbstractList | SUBJECTS/METHODS: A historical registry-based study of 76 patients referred for RC at Aarhus University Hospital, Denmark (DK) in 2009. Early rehabilitation was defined by length of stay (LOS) postoperatively with a cutoff ≤ 11 days. High comorbidity was expressed by the charlson comorbidity index score (CCI) ≥ 3. LOS was calculated by linking the unique Civil Registration Number with the National Patient Registry. Preoperative nutritional risk was identified using the screening tool, nutritional risk score 2002 (NRS) of the European Society of Clinical Nutrition and Metabolism. Multivariate analysis was used to identify risk factors for early rehabilitation. European Journal of Clinical Nutrition (2013) 67, 917-921; doi: 10.1038/ejcn.2013.120; published online 10 July 2013 INTRODUCTION: Patients diagnosed with (muscle-) invasive bladder cancer (IBC) are more likely to harbour comorbidities due to their advanced age at diagnosis. Under-nutrition is a predictor for postoperative morbidity and mortality in cancer patients, but under-reported in urology. Understanding the IBC patient profile before major surgery could facilitate and optimise outcome of the surgical patient. BACKGROUND/OBJECTIVES: To identify preoperative risk factors for early rehabilitation before radical cystectomy (RC). SUBJECTS/METHODS: A historical registry-based study of 76 patients referred for RC at Aarhus University Hospital, Denmark (DK) in 2009. Early rehabilitation was defined by length of stay (LOS) postoperatively with a cutoff ≤ 11 days. High comorbidity was expressed by the charlson comorbidity index score (CCI) ≥ 3. LOS was calculated by linking the unique Civil Registration Number with the National Patient Registry. Preoperative nutritional risk was identified using the screening tool, nutritional risk score 2002 (NRS) of the European Society of Clinical Nutrition and Metabolism. Multivariate analysis was used to identify risk factors for early rehabilitation. RESULTS: The proportion of patients at preoperative nutritional risk was 26% (95% confidence interval (CI): (95% CI: 17; 37) and 43% of patients held a high CCI (95% CI: 33; 55). Prolonged LOS was independently associated with female gender (P = 0.02) and age ≥ 70 years (P = 0.04). NRS and CCI were not associated with LOS. CONCLUSIONS: Attention should be focused on women and elderly patients undergoing RC to optimise early rehabilitation and reduce LOS. It is still unknown whether preoperative nutritional risk and comorbidity are obstacles in early rehabilitation of RC patients. European Journal of Clinical Nutrition (2013) 67, 917-921; doi: 10.1038/ejcn.2013.120; published online 10 July 2013 Keywords: nutritional risk; length of stay; rehabilitation; comorbidity; cystectomy Introduction: Patients diagnosed with (muscle-) invasive bladder cancer (IBC) are more likely to harbor comorbidities due to their advanced age at diagnosis. Under-nutrition is a predictor for postoperative morbidity and mortality in cancer patients, but under-reported in urology. Understanding the IBC patient profile before major surgery could facilitate and optimize outcome of the surgical patient. Background/objectives: To identify preoperative risk factors for early rehabilitation before radical cystectomy (RC). Subjects/methods: A historical registry-based study of 76 patients referred for RC at Aarhus University Hospital, Denmark (DK) in 2009. Early rehabilitation was defined by length of stay (LOS) postoperatively with a cutoff 11 days. High comorbidity was expressed by the charlson comorbidity index score (CCI) 3. LOS was calculated by linking the unique Civil Registration Number with the National Patient Registry. Preoperative nutritional risk was identified using the screening tool, nutritional risk score 2002 (NRS) of the European Society of Clinical Nutrition and Metabolism. Multivariate analysis was used to identify risk factors for early rehabilitation. Results: The proportion of patients at preoperative nutritional risk was 26% (95% confidence interval (CI): (95% CI: 17; 37) and 43% of patients held a high CCI (95% CI: 33; 55). Prolonged LOS was independently associated with female gender (P=0.02) and age 70 years (P=0.04). NRS and CCI were not associated with LOS. Conclusions: Attention should be focused on women and elderly patients undergoing RC to optimize early rehabilitation and reduce LOS. It is still unknown whether preoperative nutritional risk and comorbidity are obstacles in early rehabilitation of RC patients.[PUBLICATION ABSTRACT] Introduction: Patients diagnosed with (muscle-) invasive bladder cancer (IBC) are more likely to harbour comorbidities due to their advanced age at diagnosis. Under-nutrition is a predictor for postoperative morbidity and mortality in cancer patients, but under-reported in urology. Understanding the IBC patient profile before major surgery could facilitate and optimise outcome of the surgical patient. Background/objectives: To identify preoperative risk factors for early rehabilitation before radical cystectomy (RC). Subjects/methods: A historical registry-based study of 76 patients referred for RC at Aarhus University Hospital, Denmark (DK) in 2009. Early rehabilitation was defined by length of stay (LOS) postoperatively with a cutoff ⩽11 days. High comorbidity was expressed by the charlson comorbidity index score (CCI) ⩾3. LOS was calculated by linking the unique Civil Registration Number with the National Patient Registry. Preoperative nutritional risk was identified using the screening tool, nutritional risk score 2002 (NRS) of the European Society of Clinical Nutrition and Metabolism. Multivariate analysis was used to identify risk factors for early rehabilitation. Results: The proportion of patients at preoperative nutritional risk was 26% (95% confidence interval (CI): (95% CI: 17; 37) and 43% of patients held a high CCI (95% CI: 33; 55). Prolonged LOS was independently associated with female gender ( P =0.02) and age ⩾70 years ( P =0.04). NRS and CCI were not associated with LOS. Conclusions: Attention should be focused on women and elderly patients undergoing RC to optimise early rehabilitation and reduce LOS. It is still unknown whether preoperative nutritional risk and comorbidity are obstacles in early rehabilitation of RC patients. Introduction: Patients diagnosed with (muscle-) invasive bladder cancer (IBC) are more likely to harbour comorbidities due to their advanced age at diagnosis. Under-nutrition is a predictor for postoperative morbidity and mortality in cancer patients, but under-reported in urology. Understanding the IBC patient profile before major surgery could facilitate and optimise outcome of the surgical patient.Background/ objectives: To identify preoperative risk factors for early rehabilitation before radical cystectomy (RC).Subjects/ methods: A historical registry-based study of 76 patients referred for RC at Aarhus University Hospital, Denmark (DK) in 2009. Early rehabilitation was defined by length of stay (LOS) postoperatively with a cutoff less than or equal to 11 days. High comorbidity was expressed by the charlson comorbidity index score (CCI) greater than or equal to 3. LOS was calculated by linking the unique Civil Registration Number with the National Patient Registry. Preoperative nutritional risk was identified using the screening tool, nutritional risk score 2002 (NRS) of the European Society of Clinical Nutrition and Metabolism. Multivariate analysis was used to identify risk factors for early rehabilitation. Results: The proportion of patients at preoperative nutritional risk was 26% (95% confidence interval (CI): (95% CI: 17; 37) and 43% of patients held a high CCI (95% CI: 33; 55). Prolonged LOS was independently associated with female gender (P=0.02) and age greater than or equal to 70 years (P=0.04). NRS and CCI were not associated with LOS. Conclusions: Attention should be focused on women and elderly patients undergoing RC to optimise early rehabilitation and reduce LOS. It is still unknown whether preoperative nutritional risk and comorbidity are obstacles in early rehabilitation of RC patients. Introduction: Patients diagnosed with (muscle-) invasive bladder cancer (IBC) are more likely to harbour comorbidities due to their advanced age at diagnosis. Under-nutrition is a predictor for postoperative morbidity and mortality in cancer patients, but under-reported in urology. Understanding the IBC patient profile before major surgery could facilitate and optimise outcome of the surgical patient. Background/objectives: To identify preoperative risk factors for early rehabilitation before radical cystectomy (RC).Subjects/methods: A historical registry-based study of 76 patients referred for RC at Aarhus University Hospital, Denmark (DK) in 2009. Early rehabilitation was defined by length of stay (LOS) postoperatively with a cutoff ?11 days. High comorbidity was expressed by the charlson comorbidity index score (CCI) ?3. LOS was calculated by linking the unique Civil Registration Number with the National Patient Registry. Preoperative nutritional risk was identified using the screening tool, nutritional risk score 2002 (NRS) of the European Society of Clinical Nutrition and Metabolism. Multivariate analysis was used to identify risk factors for early rehabilitation. Results: The proportion of patients at preoperative nutritional risk was 26% (95% confidence interval (CI): (95% CI: 17 ; 37) and 43% of patients held a high CCI (95% CI: 33; 55). Prolonged LOS was independently associated with female gender (P=0.02) and age ?70 years (P=0.04). NRS and CCI were not associated with LOS. Conclusions: Attention should be focused on women and elderly patients undergoing RC to optimise early rehabilitation and reduce LOS. It is still unknown whether preoperative nutritional risk and comorbidity are obstacles in early rehabilitation of RC patients. Patients diagnosed with (muscle-) invasive bladder cancer (IBC) are more likely to harbour comorbidities due to their advanced age at diagnosis. Under-nutrition is a predictor for postoperative morbidity and mortality in cancer patients, but under-reported in urology. Understanding the IBC patient profile before major surgery could facilitate and optimise outcome of the surgical patient.INTRODUCTIONPatients diagnosed with (muscle-) invasive bladder cancer (IBC) are more likely to harbour comorbidities due to their advanced age at diagnosis. Under-nutrition is a predictor for postoperative morbidity and mortality in cancer patients, but under-reported in urology. Understanding the IBC patient profile before major surgery could facilitate and optimise outcome of the surgical patient.To identify preoperative risk factors for early rehabilitation before radical cystectomy (RC).BACKGROUND/OBJECTIVESTo identify preoperative risk factors for early rehabilitation before radical cystectomy (RC).A historical registry-based study of 76 patients referred for RC at Aarhus University Hospital, Denmark (DK) in 2009. Early rehabilitation was defined by length of stay (LOS) postoperatively with a cutoff ≥11 days. High comorbidity was expressed by the charlson comorbidity index score (CCI) ≥3. LOS was calculated by linking the unique Civil Registration Number with the National Patient Registry. Preoperative nutritional risk was identified using the screening tool, nutritional risk score 2002 (NRS) of the European Society of Clinical Nutrition and Metabolism. Multivariate analysis was used to identify risk factors for early rehabilitation.SUBJECTS/METHODSA historical registry-based study of 76 patients referred for RC at Aarhus University Hospital, Denmark (DK) in 2009. Early rehabilitation was defined by length of stay (LOS) postoperatively with a cutoff ≥11 days. High comorbidity was expressed by the charlson comorbidity index score (CCI) ≥3. LOS was calculated by linking the unique Civil Registration Number with the National Patient Registry. Preoperative nutritional risk was identified using the screening tool, nutritional risk score 2002 (NRS) of the European Society of Clinical Nutrition and Metabolism. Multivariate analysis was used to identify risk factors for early rehabilitation.The proportion of patients at preoperative nutritional risk was 26% (95% confidence interval (CI): (95% CI: 17; 37) and 43% of patients held a high CCI (95% CI: 33; 55). Prolonged LOS was independently associated with female gender (P=0.02) and age ≥70 years (P=0.04). NRS and CCI were not associated with LOS.RESULTSThe proportion of patients at preoperative nutritional risk was 26% (95% confidence interval (CI): (95% CI: 17; 37) and 43% of patients held a high CCI (95% CI: 33; 55). Prolonged LOS was independently associated with female gender (P=0.02) and age ≥70 years (P=0.04). NRS and CCI were not associated with LOS.Attention should be focused on women and elderly patients undergoing RC to optimise early rehabilitation and reduce LOS. It is still unknown whether preoperative nutritional risk and comorbidity are obstacles in early rehabilitation of RC patients.CONCLUSIONSAttention should be focused on women and elderly patients undergoing RC to optimise early rehabilitation and reduce LOS. It is still unknown whether preoperative nutritional risk and comorbidity are obstacles in early rehabilitation of RC patients. Introduction:Patients diagnosed with (muscle-) invasive bladder cancer (IBC) are more likely to harbour comorbidities due to their advanced age at diagnosis. Under-nutrition is a predictor for postoperative morbidity and mortality in cancer patients, but under-reported in urology. Understanding the IBC patient profile before major surgery could facilitate and optimise outcome of the surgical patient.Background/objectives:To identify preoperative risk factors for early rehabilitation before radical cystectomy (RC).Subjects/methods:A historical registry-based study of 76 patients referred for RC at Aarhus University Hospital, Denmark (DK) in 2009. Early rehabilitation was defined by length of stay (LOS) postoperatively with a cutoff ⩽11 days. High comorbidity was expressed by the charlson comorbidity index score (CCI) ⩾3. LOS was calculated by linking the unique Civil Registration Number with the National Patient Registry. Preoperative nutritional risk was identified using the screening tool, nutritional risk score 2002 (NRS) of the European Society of Clinical Nutrition and Metabolism. Multivariate analysis was used to identify risk factors for early rehabilitation.Results:The proportion of patients at preoperative nutritional risk was 26% (95% confidence interval (CI): (95% CI: 17; 37) and 43% of patients held a high CCI (95% CI: 33; 55). Prolonged LOS was independently associated with female gender (P=0.02) and age ⩾70 years (P=0.04). NRS and CCI were not associated with LOS.Conclusions:Attention should be focused on women and elderly patients undergoing RC to optimise early rehabilitation and reduce LOS. It is still unknown whether preoperative nutritional risk and comorbidity are obstacles in early rehabilitation of RC patients. Patients diagnosed with (muscle-) invasive bladder cancer (IBC) are more likely to harbour comorbidities due to their advanced age at diagnosis. Under-nutrition is a predictor for postoperative morbidity and mortality in cancer patients, but under-reported in urology. Understanding the IBC patient profile before major surgery could facilitate and optimise outcome of the surgical patient. To identify preoperative risk factors for early rehabilitation before radical cystectomy (RC). A historical registry-based study of 76 patients referred for RC at Aarhus University Hospital, Denmark (DK) in 2009. Early rehabilitation was defined by length of stay (LOS) postoperatively with a cutoff ≥11 days. High comorbidity was expressed by the charlson comorbidity index score (CCI) ≥3. LOS was calculated by linking the unique Civil Registration Number with the National Patient Registry. Preoperative nutritional risk was identified using the screening tool, nutritional risk score 2002 (NRS) of the European Society of Clinical Nutrition and Metabolism. Multivariate analysis was used to identify risk factors for early rehabilitation. The proportion of patients at preoperative nutritional risk was 26% (95% confidence interval (CI): (95% CI: 17; 37) and 43% of patients held a high CCI (95% CI: 33; 55). Prolonged LOS was independently associated with female gender (P=0.02) and age ≥70 years (P=0.04). NRS and CCI were not associated with LOS. Attention should be focused on women and elderly patients undergoing RC to optimise early rehabilitation and reduce LOS. It is still unknown whether preoperative nutritional risk and comorbidity are obstacles in early rehabilitation of RC patients. |
| Audience | Professional Academic |
| Author | Petersen, A K Lash, T L Jensen, B T Soendergaard, I Ernst-Jensen, K M Laustsen, S Borre, M |
| Author_xml | – sequence: 1 givenname: B T orcidid: 0000-0003-4576-5042 surname: Jensen fullname: Jensen, B T email: benjense@rm.dk organization: Department of Urology, Aarhus University Hospital, Department of Clinical Medicine, Centre of Research in Rehabilitation, Aarhus University – sequence: 2 givenname: S surname: Laustsen fullname: Laustsen, S organization: Department of Clinical Medicine, Centre of Research in Rehabilitation, Aarhus University, Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital (DK) – sequence: 3 givenname: A K surname: Petersen fullname: Petersen, A K organization: Department of Clinical Medicine, Centre of Research in Rehabilitation, Aarhus University, Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital – sequence: 4 givenname: M surname: Borre fullname: Borre, M organization: Department of Hepatology and Gastroenterology, Aarhus University Hospital (DK) – sequence: 5 givenname: I surname: Soendergaard fullname: Soendergaard, I organization: Department of Urology, Aarhus University Hospital – sequence: 6 givenname: K M surname: Ernst-Jensen fullname: Ernst-Jensen, K M organization: Department of Urology, Aarhus University Hospital – sequence: 7 givenname: T L surname: Lash fullname: Lash, T L organization: Department of Clinical Epidemiology, Aarhus University Hospital (DK), Department of Epidemiology, Rollins School of Public Health, Emory University (US) – sequence: 8 givenname: M surname: Borre fullname: Borre, M organization: Department of Urology, Aarhus University Hospital |
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| CitedBy_id | crossref_primary_10_1590_s1677_5538_ibju_2017_0282 crossref_primary_10_5410_wjcu_v5_i1_53 crossref_primary_10_1097_MOU_0000000000000487 crossref_primary_10_1007_s00345_020_03291_z crossref_primary_10_1080_01635581_2017_1367941 crossref_primary_10_1111_iju_13228 crossref_primary_10_1016_j_jgo_2023_101468 crossref_primary_10_1186_s12957_023_03207_2 crossref_primary_10_1007_s00092_015_0490_y |
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| Keywords | cystectomy length of stay rehabilitation comorbidity nutritional risk Urinary system disease Nutrition Metabolic diseases Risk Duration Urinary tract disease Malignant tumor Bladder cancer Concomitant disease Risk factor Rehabilitation(human) Bladder disease Preoperative Rehabilitation Cancer |
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| Snippet | Introduction:
Patients diagnosed with (muscle-) invasive bladder cancer (IBC) are more likely to harbour comorbidities due to their advanced age at diagnosis.... Patients diagnosed with (muscle-) invasive bladder cancer (IBC) are more likely to harbour comorbidities due to their advanced age at diagnosis.... INTRODUCTION: Patients diagnosed with (muscle-) invasive bladder cancer (IBC) are more likely to harbour comorbidities due to their advanced age at diagnosis.... SUBJECTS/METHODS: A historical registry-based study of 76 patients referred for RC at Aarhus University Hospital, Denmark (DK) in 2009. Early rehabilitation... Introduction: Patients diagnosed with (muscle-) invasive bladder cancer (IBC) are more likely to harbor comorbidities due to their advanced age at diagnosis.... Introduction:Patients diagnosed with (muscle-) invasive bladder cancer (IBC) are more likely to harbour comorbidities due to their advanced age at diagnosis.... Introduction: Patients diagnosed with (muscle-) invasive bladder cancer (IBC) are more likely to harbour comorbidities due to their advanced age at diagnosis.... |
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| SubjectTerms | 692/499 692/699/67/589/1336 692/700/2814 692/700/565/491 Aged Biological and medical sciences Bladder Bladder cancer Cancer Care and treatment Clinical Nutrition Comorbidity Confidence intervals Cystectomy - methods Denmark Epidemiology Feeding. Feeding behavior Female Females Fundamental and applied biological sciences. Psychology Humans Internal Medicine Invasiveness Length of Stay Male Malnutrition Malnutrition - epidemiology Medical sciences Medicine Medicine & Public Health Metabolic Diseases Morbidity Mortality Multivariate Analysis Muscles Nephrology. Urinary tract diseases Nutrition Nutrition therapy original-article Patients Physiological aspects Postoperative Period Preoperative Period Prevalence Public Health Registries Rehabilitation Risk analysis Risk Factors Risk factors (Health) Surgery Treatment Outcome Tumors of the urinary system Urinary Bladder Neoplasms - epidemiology Urinary Bladder Neoplasms - rehabilitation Urinary Bladder Neoplasms - surgery Urinary tract. Prostate gland Urology Vertebrates: anatomy and physiology, studies on body, several organs or systems |
| Title | Preoperative risk factors related to bladder cancer rehabilitation: a registry study |
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