FACTORS PREDICTING POOR OUTCOME FOLLOWING NEPHROSTOMY INSERTION IN ACUTE MALIGNANT URETERIC OBSTRUCTION
Author(s):
Dr Tariro Nadine Gandiya
,
Dr Tariro Nadine Gandiya
Affiliations:
Mr Rajan Veeratterapillay
,
Mr Rajan Veeratterapillay
Affiliations:
Mr Andrew Thorpe
Mr Andrew Thorpe
Affiliations:
BAUS ePoster online library. Gandiya T. 06/26/17; 177351; P2-5
Dr. Tariro Nadine Gandiya
Dr. Tariro Nadine Gandiya
Login now to access Regular content available to all registered users.

You may also access this content "anytime, anywhere" with the Free MULTILEARNING App for iOS and Android
Abstract
Discussion Forum (0)
Rate & Comment (0)
Acute malignant ureteric obstruction(MUO) can be a difficult to manage. Percutaneous nephrostomy (PCN) insertion in the acute setting often corrects renal function but does not alter the disease course. Nephrostomy insertion is associated with morbidity and can significantly impact patients' quality of life. We sought to identify factors associated with poor outcome following PCN insertion for MUO.

Methods
Consecutive patients (Jan2012-Dec2014) presenting acutely to a tertiary referral centre with MUO and having PCN insertion were identified from a prospective departmental database. Retrospective review was undertaken to extract demographic data,ECOG performance status, oncological data (malignancy type,cancer therapy, presence of metastases),laboratory data(serum albumin, CRP, creatinine at presentation) and survival. ‘Poor outcome’ was defined as survival <30days following PCN. Univariate and multivariate analysis were used to identify factors associated with poor outcome. Kaplan Meier plots were used for survival analysis.

Results
193 patients (median age 70, range 26-90years) had PCN for MUO in this period. 132 (68%) patients died during the study period, 23 (12%) having a survival of <30 days after PCN insertion. Primary malignancy were urological (47%), gynaecological (22%),colorectal (11%) and other(20%). 130 patients (67%) had prior oncological treatment at presentation. Kaplan Meier analysis showed 1, 3 and 6 month survival of 82%, 63% and 50% respectively. Factors associated with ‘poor outcome’ were ECOG performance status ≤2 (p=0.04), low albumin (p=0.03) and prior treatment for malignancy(p=0.03).

Conclusion
PCN insertion in acute MUO results in 50% survival at 6 months. Predictors of survival of <30 days are low serum albumin, prior oncological treatment and poor performance status. This can guide patient counselling.
Acute malignant ureteric obstruction(MUO) can be a difficult to manage. Percutaneous nephrostomy (PCN) insertion in the acute setting often corrects renal function but does not alter the disease course. Nephrostomy insertion is associated with morbidity and can significantly impact patients' quality of life. We sought to identify factors associated with poor outcome following PCN insertion for MUO.

Methods
Consecutive patients (Jan2012-Dec2014) presenting acutely to a tertiary referral centre with MUO and having PCN insertion were identified from a prospective departmental database. Retrospective review was undertaken to extract demographic data,ECOG performance status, oncological data (malignancy type,cancer therapy, presence of metastases),laboratory data(serum albumin, CRP, creatinine at presentation) and survival. ‘Poor outcome’ was defined as survival <30days following PCN. Univariate and multivariate analysis were used to identify factors associated with poor outcome. Kaplan Meier plots were used for survival analysis.

Results
193 patients (median age 70, range 26-90years) had PCN for MUO in this period. 132 (68%) patients died during the study period, 23 (12%) having a survival of <30 days after PCN insertion. Primary malignancy were urological (47%), gynaecological (22%),colorectal (11%) and other(20%). 130 patients (67%) had prior oncological treatment at presentation. Kaplan Meier analysis showed 1, 3 and 6 month survival of 82%, 63% and 50% respectively. Factors associated with ‘poor outcome’ were ECOG performance status ≤2 (p=0.04), low albumin (p=0.03) and prior treatment for malignancy(p=0.03).

Conclusion
PCN insertion in acute MUO results in 50% survival at 6 months. Predictors of survival of <30 days are low serum albumin, prior oncological treatment and poor performance status. This can guide patient counselling.
Code of conduct/disclaimer available in General Terms & Conditions

By clicking “Accept Terms & all Cookies” or by continuing to browse, you agree to the storing of third-party cookies on your device to enhance your user experience and agree to the user terms and conditions of this learning management system (LMS).

Cookie Settings
Accept Terms & all Cookies