TY - JOUR
T1 - Comprehensive assessment of the morbidity of renal mass biopsy
T2 - A populationbased assessment of biopsy-related complications
AU - Garbens, Alaina
AU - Wallis, Christopher J.D.
AU - Klaassen, Zachary
AU - Saskin, Refik
AU - Plumptre, Lesley
AU - Kodama, Ronald
AU - Herschorn, Sender
AU - Nam, Robert K.
N1 - Funding Information:
Funding/Acknowledgment: Dr. Nam is supported by the Ajmera Family Chair in Urologic Oncology. This study made use of de-identified data from the ICES Data Repository, which is managed by the Institute for Clinical Evaluative Sciences with support from its funders and partners: Canada’s Strategy for Patient-Oriented Research (SPOR), the Ontario SPOR Support Unit, the Canadian Institutes of Health Research and the Government of Ontario. The opinions, results and conclusions reported are those of the authors. No endorsement by ICES of any of its funders or partners is intended or should be inferred
Publisher Copyright:
© 2020 Canadian Urological Association.
PY - 2020/7
Y1 - 2020/7
N2 - Introduction: We sought to assess seven-day and 30-day complications following renal mass biopsy (RMB), including mortality, hospitalizations, emergency department (ED) visits, and operative and non-operative complications and compare these to rates in population matched controls. Methods: We performed a population-based, matched, retrospective cohort study of patients undergoing RMB following consultation with a urologist and axial imaging from 2003-2015 in Ontario, Canada. Data on seven-day and 30-day rates of mortality, operative and non operative complications after RMB were reported. The seven-day and 30-day rates of mortality, operative and non-operative interventions, hospitalizations, and ED visits were compared to matched controls using multivariable logistic regression. Results: Among 6840 patients who underwent RMB in the study period, 24 (0.4%) and 159 (2.3%) died within seven and 30 days, respectively, of their biopsy. Seven-and 30-day operative intervention rates were 79 (1.2%) and 236 (3.4%), respectively. Sevenand 30-day non-operative intervention rates were 227 (3.3%) and 529 (7.7%) respectively. Thirty-day mortality (odds ratio [OR] 8.1; 95% confidence interval [CI] 5.1-13.0), hospitalizations (OR 12.6; 95% CI 10.6-15.2), and ED visits (OR 3.8; 95% CI 3.4-4.3) were more common among patients who underwent RMB than the matched controls (p<0.001 for each). Conclusions: Patients undergoing RMB may have a small but non-negligible increased risk of mortality, hospital readmission, and ED visits compared to matched controls. However, limitations in the granularity of the dataset limits the strength of these conclusions. Further studies are needed to confirm our results. These risks should be discussed with patients for shared decision-making and considered in the risk/benefit tradeoff for the management of small renal masses.
AB - Introduction: We sought to assess seven-day and 30-day complications following renal mass biopsy (RMB), including mortality, hospitalizations, emergency department (ED) visits, and operative and non-operative complications and compare these to rates in population matched controls. Methods: We performed a population-based, matched, retrospective cohort study of patients undergoing RMB following consultation with a urologist and axial imaging from 2003-2015 in Ontario, Canada. Data on seven-day and 30-day rates of mortality, operative and non operative complications after RMB were reported. The seven-day and 30-day rates of mortality, operative and non-operative interventions, hospitalizations, and ED visits were compared to matched controls using multivariable logistic regression. Results: Among 6840 patients who underwent RMB in the study period, 24 (0.4%) and 159 (2.3%) died within seven and 30 days, respectively, of their biopsy. Seven-and 30-day operative intervention rates were 79 (1.2%) and 236 (3.4%), respectively. Sevenand 30-day non-operative intervention rates were 227 (3.3%) and 529 (7.7%) respectively. Thirty-day mortality (odds ratio [OR] 8.1; 95% confidence interval [CI] 5.1-13.0), hospitalizations (OR 12.6; 95% CI 10.6-15.2), and ED visits (OR 3.8; 95% CI 3.4-4.3) were more common among patients who underwent RMB than the matched controls (p<0.001 for each). Conclusions: Patients undergoing RMB may have a small but non-negligible increased risk of mortality, hospital readmission, and ED visits compared to matched controls. However, limitations in the granularity of the dataset limits the strength of these conclusions. Further studies are needed to confirm our results. These risks should be discussed with patients for shared decision-making and considered in the risk/benefit tradeoff for the management of small renal masses.
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U2 - 10.5489/CUAJ.6477
DO - 10.5489/CUAJ.6477
M3 - Article
AN - SCOPUS:85090510544
SN - 1911-6470
VL - 15
JO - Journal of the Canadian Urological Association
JF - Journal of the Canadian Urological Association
IS - 2
ER -