Presented by: Antonio Franco
Rush university medical center

Introduction

Socioeconomic determinants of health (SDOH) are often unvalued during surgery risk stratification; hence, they might be a major source of disparity that can jeopardize outcomes related to urological surgery. The aim of our study is to evaluate the impact of SDOH on postoperative outcomes following robotic radical prostatectomy (RARP).

Materials

Patients who underwent RARP between 2011 and 2021 were retrospectively analyzed by using PearlDiver-Mariner, an all-payer insurance claims database. International Classification of Diseases diagnosis and procedure codes were used to identify patient’s characteristics, postoperative complications and SDOH. Outcomes were compared using multivariable regression models.

Results

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Overall, 100,035 patients (mean age = 63.24±7.07) underwent RARP. The 60-day postoperative complication rate was 11%. Approximately 6% of patients reported at least one SDOH at baseline. SDOH were associated with higher odds of 60-day postoperative complications (OR:1.24, 95% CI:1.15-1.34), including urinary tract infection (OR:1.32, 95% CI:1.20-1.45), pulmonary embolism (OR:1.21, 95% CI:0.95-1.52), acute kidney injury (OR:1.31, 95% CI:0.98-1.29) and postoperative urethral stricture (OR:1.37, 95% CI:0.92-1.98).

Conclusion

Patients with SDOH have significantly higher risk of postoperative complications following RARP, especially urinary infection and acute kidney injury. Early identification of these groups may help stratify high-risk patients diagnosed with prostate cancer, in order to accurately counsel them.

Funding

None

Co-Authors

Morgan R. Sturgis, MD
Rush university medical center

Francesco Ditonno, MD
Rush university medical center

Celeste Manfredi,
Rush university medical center

Jamie Yoon,
Rush university medical center

Daniel Roadman,
Rush university medical center

Adan Z. Becerra,
Rush university medical center

Srinivas Vourganti,
Rush university medical center

Ephrem O. Olweny,
Rush university medical center

Riccardo Autorino,
Rush university medical center