title: Rhabdomyolysis After Major Urologic Surgery: Epidemiology, Risk Factors, and Outcomes.
abstract: OBJECTIVE
  To study the epidemiology, risk factors, and outcomes of rhabdomyolysis (RM) after major urologic surgery.
  
  
  METHODS
  The National Inpatient Sample (2003-2011) was used to identify patients who underwent radical prostatectomy, radical or partial nephrectomy, or radical cystectomy. Demographics included age, sex, race, and comorbidities. Factors examined included bleeding, hospital teaching status, minimally invasive technique, and development of RM. Multivariate logistic regression was used to identify independent risk factors of RM. Outcomes of mortality, acute kidney injury (AKI), length of stay, and charges in patients with RM were compared with those of controls.
  
  
  RESULTS
  A weighted population of 1,016,074 patients was identified with 870 (0.1%) developing RM, which was significantly more likely for radical or partial nephrectomy and radical cystectomy patients compared with radical prostatectomy patients. On multivariate analysis, independent risk factors for RM included younger age, male sex, diabetes, chronic kidney disease, obesity, and bleeding. Race, minimally invasive technique, and teaching status were not associated with RM when controlling for other factors. Patients with RM experienced increases in mortality, AKI, length of stay, and hospital charges.
  
  
  CONCLUSIONS
  Rhabdomyolysis is a rare complication after urologic surgery. Risk factors include male sex, younger age, diabetes, chronic kidney disease, obesity, and perioperative bleeding. Patients who develop RM have a higher risk of AKI, mortality, prolonged hospital stay, and increased charges.
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago, Chicago, IL. Electronic address: pariserj@gmail.com.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Pariser
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago, Chicago, IL.
authors.forename: Shane M
authors.initials: SM
authors.lastname: Pearce
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago, Chicago, IL.
authors.forename: Sanjay G
authors.initials: SG
authors.lastname: Patel
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago, Chicago, IL.
authors.forename: Blake B
authors.initials: BB
authors.lastname: Anderson
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago, Chicago, IL.
authors.forename: Vignesh T
authors.initials: VT
authors.lastname: Packiam
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago, Chicago, IL.
authors.forename: Arieh L
authors.initials: AL
authors.lastname: Shalhav
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago, Chicago, IL.
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Bales
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago, Chicago, IL.
authors.forename: Norm D
authors.initials: ND
authors.lastname: Smith
mesh_terms: D015653:Cystectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009392:Nephrectomy; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D011468:Prostatectomy; D012206:Rhabdomyolysis / Q000453:epidemiology*; D018570:Risk Assessment; D012307:Risk Factors