Abstract：
PURPOSE:Partial nephrectomy (PN) outcomes may be better at academic institutions than at non-academic centers. Peer-review, sub-specialized practice profile, higher individual surgeon and institutional caseload may explain this observation. To the best of our knowledge, the role of institutional academic affiliation has not been examined with regard to PN postoperative outcomes. METHODS:Within the Health Care Utilization Project Nationwide Inpatient Sample (NIS), we focused on PNs performed within the 10 most contemporary years (1998-2007). We explored the effect of academic status on three short-term PN outcomes (intraoperative and postoperative complications, as well as in-hospital mortality). Multivariable logistic regression analyses further adjusted for age, race, gender, Charlson Comorbidity Index (CCI), surgical approach, hospital region, annual hospital caseload and insurance status. RESULTS:Overall, 8,513 PNs were identified. Of those, 5,906 (69.4%) were recorded at academic institutions. Academic institution patients had lower CCI, were less frequently Caucasian and more frequently had private insurance (all P < 0.001). Academic institution PNs were associated with fewer postoperative complications (14.6% vs. 16.6%, P = 0.018). In multivariable analyses, institutional academic status did not affect the three short-term PN outcomes. CONCLUSIONS:Patient selection explains better PN postoperative outcomes at academic institutions. Control for these biases removes the outcome differences, at least when the three short-term PN outcomes are considered. However, the interpretation of these findings needs to take into account the lack of adjustment for case complexity.
journal_name
World J Uroljournal_title
World journal of urologyauthors
Trinh QD,Schmitges J,Sun M,Sammon J,Shariat SF,Sukumar S,Zorn K,Bianchi M,Jeldres C,Perrotte P,Graefen M,Rogers CG,Peabody JO,Menon M,Karakiewicz PIdoi
10.1007/s00345-011-0759-zsubject
Has Abstractpub_date
2012-08-01 00:00:00pages
505-10issue
4eissn
0724-4983issn
1433-8726journal_volume
30pub_type
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