caa a22 4500 445335661 CHVBK 20180317142754.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1245/s10434-011-1757-5 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1757-5 Adrenalectomy in Older Americans has Increased Morbidity and Mortality: An Analysis of 6,416 Patients [Elektronische Daten] [Hadiza Kazaure, Sanziana Roman, Julie Sosa] Background: The incidence of adrenal tumors increases with age. We examined the impact of older age (>60years) on clinical and economic outcomes after adrenalectomy. Methods: 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: ≤60years, 61-70years, and >70years. Outcomes were compared using χ2 and ANOVA; multivariate regression was used to assess the independent effect of older age on adrenalectomy outcomes. Results: There were 6,416 patients: 21.9% were 61-70years, and 12.9% were >70years. Compared with patients ≤60years, patients 61-70 and >70years 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 4.9days; 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 61-70years; OR 1.7, 95% CI 1.3-2.2 for patients >70years) and longer adjusted LOS (1-day difference, p<0.01). Age >70years 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. Conclusions: 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. Society of Surgical Oncology, 2011 Kazaure Hadiza Division of Endocrine Surgery, Department of Surgery, Yale University School of Medicine, 330 Cedar St, Tompkins 208, New Haven, CT, USA aut Roman Sanziana Division of Endocrine Surgery, Department of Surgery, Yale University School of Medicine, 330 Cedar St, Tompkins 208, New Haven, CT, USA aut Sosa Julie Division of Endocrine Surgery, Department of Surgery, Yale University School of Medicine, 330 Cedar St, Tompkins 208, New Haven, CT, USA aut Annals of Surgical Oncology Springer-Verlag 18/10(2011-10-01), 2714-2721 1068-9265 18:10<2714 2011 18 10434 https://doi.org/10.1245/s10434-011-1757-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1757-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kazaure Hadiza Division of Endocrine Surgery, Department of Surgery, Yale University School of Medicine, 330 Cedar St, Tompkins 208, New Haven, CT, USA aut NATIONALLICENCE 700 1- Roman Sanziana Division of Endocrine Surgery, Department of Surgery, Yale University School of Medicine, 330 Cedar St, Tompkins 208, New Haven, CT, USA aut NATIONALLICENCE 700 1- Sosa Julie Division of Endocrine Surgery, Department of Surgery, Yale University School of Medicine, 330 Cedar St, Tompkins 208, New Haven, CT, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/10(2011-10-01), 2714-2721 1068-9265 18:10<2714 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer