Adrenalectomy in Older Americans has Increased Morbidity and Mortality: An Analysis of 6,416 Patients

Abstract

The incidence of adrenal tumors increases with age. We examined the impact of older age (>60 years) on clinical and economic outcomes after adrenalectomy. Adult patients who underwent adrenalectomy in the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS) from 2003–2008 were categorized into age groups: ≤60 years, 61–70 years, and >70 years. Outcomes were compared using χ2 and ANOVA; multivariate regression was used to assess the independent effect of older age on adrenalectomy outcomes. There were 6,416 patients: 21.9% were 61–70 years, and 12.9% were >70 years. Compared with patients ≤60 years, patients 61–70 and >70 years had more complications (14.1% vs. 19.9 and 22.6%; p < 0.001) and mortality (0.4% vs. 1.3 and 2.3%; p < 0.001), longer mean length of stay (LOS) (3.3 vs. 4.0 and 4.9 days; p < 0.001), and higher mean costs ($12,307 vs. $13,226 and $14,649; p < 0.001). After adjustment, older age remained independently associated with sustaining one or more complications after adrenalectomy (odds ratio (OR) 1.4, 95% confidence interval (CI) 1.1–1.7, for patients 61–70 years; OR 1.7, 95% CI 1.3–2.2 for patients >70 years) and longer adjusted LOS (1-day difference, p < 0.01). Age >70 years was independently associated with increased mortality after adrenalectomy (OR 2.8; 95% CI 1.4–5.6). Complications, LOS, and costs were reduced if patients underwent surgery by high-volume compared with low-volume surgeons. Older age seems to be independently associated with adverse short-term clinical and economic outcomes after adrenalectomy. Enhanced access to high-volume surgeons is a potentially modifiable factor of particular importance in these patients.

DOI: 10.1245/s10434-011-1757-5

6 Figures and Tables

Statistics

0100200300201220132014201520162017
Citations per Year

152 Citations

Semantic Scholar estimates that this publication has 152 citations based on the available data.

See our FAQ for additional information.

Cite this paper

@article{BSc2011AdrenalectomyIO, title={Adrenalectomy in Older Americans has Increased Morbidity and Mortality: An Analysis of 6,416 Patients}, author={Hadiza S. Kazaure BSc and Sanziana A Roman and MD Julie A. Sosa MA}, journal={Annals of Surgical Oncology}, year={2011}, volume={18}, pages={2714-2721} }