Morbidity and Mortality Following Radical Prostatectomy: A National Analysis of Civilian Health and Medical Program of the Uniformed Services Beneficiaries

Abstract

Recent evidence from an analysis of Medicare patients undergoing radical prostatectomy has suggested that perioperative mortality may be substantially greater than that reported in institutional series. To estimate the perioperative mortality and survival of patients of a younger and potentially more representative population of the United States, Civilian Health and Medical Program of the Uniformed Services institutional claims data from October 1, 1987 to January 1, 1993 were analyzed. A total of 1,059 subjects was examined of an average age of 60.0 years and all were younger than 65 years. Using Kaplan-Meier estimates, mortality rates following surgery were calculated to be 0.28 percent at 30 days, 0.28 percent at 90 days, 1.02 percent at 1 year, 1.95 percent at 2 years, 3.14 percent at 3 years and 4.64 percent at 4 years. Observed 1 to 5 mortality rates in this series ranged from 0.362 to 0.487 of the expected mortality when compared to the general population and they were statistically significant. At 30 and 90 days postoperatively 3.1 percent and 4.6 percent of the patients were rehospitalized. Data demonstrated that mortality and morbidity from radical prostatectomy were low and that conclusions drawn on outcomes of treatment for carcinoma of the prostate should focus on the entire age range of patients who undergo this procedure in the United States.