Background: 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/m) was associated with worse perioperative outcomes and if there were heterogeneous effects based on race, ethnicity, and neighborhood-level socioeconomic factor.
Methods: 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].
Results: 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/m, 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/m 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 <30 kg/m, 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.
Conclusions: In this study, obesity increased likelihood of worse perioperative outcomes, and the associations varied based on race and ethnicity and neighborhood-level socioeconomic factors.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11074675 | PMC |
http://dx.doi.org/10.21037/tau-23-421 | DOI Listing |
Genet Med
December 2024
Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN; Center for Digital Genomic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN. Electronic address:
Purpose: The value of genetic information for improving the performance of clinical risk prediction models has yielded variable conclusions. Many methodological decisions have the potential to contribute to differential results. We performed multiple modeling experiments integrating clinical and demographic data from electronic health records (EHR) with genetic data to understand which decisions may affect performance.
View Article and Find Full Text PDFJ Eval Clin Pract
February 2025
Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
Rationale: Chronic pelvic pain syndrome (CPPS) is prevalent and a complex multifactorial condition. The incidence is rising. CPPS patients may benefit from multidisciplinary care in a structured care pathway.
View Article and Find Full Text PDFJ Eval Clin Pract
February 2025
Nursing Department, Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Türkiye.
Introduction: Implementation of clinical practice guidelines, an important strategy in the prevention of pressure injuries, enables the nurse to interpret evidence-based guideline recommendations, reduce errors, ensure compliance and standardisation of complex processes, manage patient-related risks and systematically regulate all preventable conditions.
Objective: This study was conducted to ensure the Turkish language and content validity of the Standardised Pressure Injury Prevention Protocol (SPIPP- Adult) Checklist 2.0.
J Eval Clin Pract
February 2025
Initiative for Slow Medicine, Berkeley, California, USA.
Appropriate patient reassurance is an essential feature of clinical practice. My recent experience as a patient, interpreted via my expertise as a health services researcher, led me to insights on ideal and suboptimal reassurance styles in the context of worrisome symptoms. Reassurance is complex: often poorly defined in the scientific literature, rarely rigorously studied, imperfectly understood, and requiring some adaptation to each patient situation.
View Article and Find Full Text PDFJ Eval Clin Pract
February 2025
Instituto Mexicano del Seguro Social, IMSS Hospital General de Zona Número 17, Monterrey, Nuevo León, México.
Introduction: Rheumatoid arthritis (RA) is a progressive autoimmune inflammatory disease. According to the European League Against Rheumatism (EULAR), the stages of RA progression include pre-RA, preclinical RA, inflammatory arthralgia, arthralgia with positive antibodies, arthralgia suspected of progressing to RA, undifferentiated arthritis and finally established RA. According to the Community Oriented Program for Control of Rheumatic Diseases (COPCORD), the prevalence of RA in Mexico is 1.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!