Safety of Transurethral Resection of Bladder Tumor in Octogenarians: A NSQIP Analysis

While transurethral resection of bladder tumor (TURBT) is frequently described as a minor procedure to patients, it can be associated with significant morbidity. We evaluated the rates of post-operative complications after TURBT in octogenarians versus in younger patients and investigated whether age ≥80 years was an independent risk factor for adverse outcomes. We conducted a review of the American College of Surgeons National Surgical Quality Improvement Program database from 2012-2022, excluding patients with disseminated cancer, pre-operative sepsis, or who were ventilator-dependent.

We identified 78,665 reports of TURBT, of which 21,627 (27.5%) were performed on patients aged ≥80. In multivariate analysis, age ≥80 was significantly associated with septic shock (OR 2.29; 95% CI 1.44-3.66), receipt of blood transfusion ≤72 hours (OR 1.42; 95% CI 1.20-1.67), prolonged post-operative stay ≥1 day (OR 1.50; 95% CI 1.43-1.57), unplanned related readmission (OR 1.26; 95% CI 1.15-1.38), and death (OR 2.74; 95% CI 2.15-3.52). Age was not associated with increased risk of UTI, sepsis, DVT, PE, or unplanned related reoperation. However, age ≥80 was associated with a lower risk of prolonged operation time ≥90min (OR 0.87; 95% CI 0.79-0.96).

While TURBT in octogenarians has a low incidence of complications overall, clinicians should remain mindful of the increased risk of complications for pre-operative counseling and discharge preparation.

Written by: David S. Wang, MD, BU Chobanian & Avedisian School of Medicine, Boston Medical Center, Department of Urology, Boston, MA

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