■肥胖是肾细胞癌(RCC)的公认危险因素,然而,肥胖对RCC患者手术结局的影响尚不清楚.这项研究调查了较高的体重指数(BMI)或肥胖(BMI≥30kg/m2)是否与较差的围手术期结局有关,以及是否存在基于种族的异质性效应。种族,和邻里层面的社会经济因素。
■在这项单中心横截面研究中,我们对2010~2022年间接受部分肾切除术或根治性肾切除术的患者的病历进行了回顾性分析.进行Logistic回归分析以评估BMI与围手术期结局的关系[缺血时间,估计失血量(EBL),和住院时间]。
■总共432名患者,包括49.8%的非西班牙裔白人(NHW),35.0%西班牙裔,和6.9%的美洲印第安人(AI)患者,包括在内。中位数[四分位距(IQR)]BMI为30.2(26.3-35.2)kg/m2,西班牙裔(31.5)和AI(32.5)患者的中位数BMI高于NHW(29.1)患者(P=0.006)。缺血时间中位数,EBL,住院时间为18.5(IQR,15.0-22.4)分钟,150(IQR,75.0-300.0)mL,和3(IQR,2-5)天。BMI≥35kg/m2与较长的缺血时间相关[>18.5分钟;比值比(OR),5.17;95%置信区间(CI):1.81-14.76;P=0.002],NHW患者的关联比西班牙裔患者更强(BMI连续OR,1.13;95%CI:1.04-1.22;NHW和OR中的P=0.004,1.07;95%CI:0.98-1.17;西班牙裔P=0.12)。与体重正常的患者相比,I级和II/III级肥胖患者的EBL(>150mL)增加了两倍以上(OR,2.17;95%CI:1.03-4.59;I类和OR类P=0.04,2.24;95%CI:1.04-4.84;II/III类肥胖患者P=0.04)。在来自高社会剥夺指数(SDI)社区的患者和NHW患者中,这种关联更强(BMI≥30vs.<30kg/m2,OR,3.53;95%CI:1.57-7.97;高SDI邻域P=0.002,OR,2.38;95%CI:1.10-5.14;NHW中P=0.03)。BMI与住院时间延长无关。
■在这项研究中,肥胖增加了不良围手术期结局的可能性,这些协会因种族和族裔以及邻里层面的社会经济因素而异。
UNASSIGNED: Obesity is a well-established risk factor of renal cell carcinoma (RCC), however the impact of obesity on surgical outcomes for racial and ethnic minority patients with RCC is unclear. This study investigated whether a higher body mass index (BMI) or obesity (BMI ≥30 kg/m2) was associated with worse perioperative outcomes and if there were heterogeneous effects based on race, ethnicity, and neighborhood-level socioeconomic factor.
UNASSIGNED: In this single-center cross-sectional study, medical records of patients who underwent partial or radical nephrectomy between 2010 and 2022 were retrospectively reviewed. Logistic regression analysis was performed to assess associations of BMI and perioperative outcomes [ischemia time, estimated blood loss (EBL), and length of hospital stay].
UNASSIGNED: A total of 432 patients, including 49.8% non-Hispanic White (NHW), 35.0% Hispanic, and 6.9% American Indian (AI) patients, were included. Median [interquartile range (IQR)] BMI was 30.2 (26.3-35.2) kg/m2, and Hispanic (31.5) and AI (32.5) patients had higher median BMI than NHW (29.1) patients (P=0.006). Median ischemia time, EBL, and length of hospital stay were 18.5 (IQR, 15.0-22.4) minutes, 150 (IQR, 75.0-300.0) mL, and 3 (IQR, 2-5) days. BMI ≥35 kg/m2 was associated with a longer ischemia time [>18.5 minutes; odds ratio (OR), 5.17; 95% confidence interval (CI): 1.81-14.76; P=0.002], and the association was stronger in NHW than Hispanic patients (BMI continuous OR, 1.13; 95% CI: 1.04-1.22; P=0.004 in NHW and OR, 1.07; 95% CI: 0.98-1.17; P=0.12 in Hispanics). Class I and II/III obese patients had over two-fold increased odds of a larger EBL (>150 mL) than patients with normal weight (OR, 2.17; 95% CI: 1.03-4.59; P=0.04 for class I and OR, 2.24; 95% CI: 1.04-4.84; P=0.04 for class II/III obese patients). This association was stronger in patients from neighborhoods with high social deprivation index (SDI) and in NHW patients (BMI ≥30 vs. <30 kg/m2, OR, 3.53; 95% CI: 1.57-7.97; P=0.002 in high SDI neighborhoods and OR, 2.38; 95% CI: 1.10-5.14; P=0.03 in NHW). BMI was not associated with a longer hospital stay.
UNASSIGNED: In this study, obesity increased likelihood of worse perioperative outcomes, and the associations varied based on race and ethnicity and neighborhood-level socioeconomic factors.