The Effect of Valvulopathy on Adverse In-Hospital Outcomes After Partial and Radical Nephrectomy

Background: The effect of valvulopathy on adverse in-hospital outcomes after partial nephrectomy (PN) and radical nephrectomy (RN) is unknown. Patients and Methods: Descriptive analyses, 1:2 propensity score matching and multivariable logistic and Poisson regression models were used to address National Inpatient Sample (2000–2019) patients with kidney cancer who underwent PN and RN, stratified according to presence or absence of valvulopathy. Results: Overall, 38,673 patients underwent PN versus 92,072 RN. Of those, 836 (2.2%) and 2651 (2.9%) had valvulopathy, respectively. Valvulopathy rate decreased from 3.04 to 1.57% in PN patients (2000–2019, EAPC: −1.74%, p = 0.02), and from 2.97 to 2.28% in RN patients (2000–2019, EAPC: −0.94%, p = 0.01). RN patients with valvulopathy were older and carried a higher number of comorbidities than PN patients with valvulopathy. Valvulopathy in PN patients independently predicted higher rates of adverse in-hospital outcomes in 7 of 14 examined categories, with odds ratio (OR) ranging from 2.96 for cardiac complications to 2.35 for vascular complications and 1.78 for bleeding complications (all p < 0.05), but not in-hospital mortality (p > 0.05). Valvulopathy in RN patients independently predicted higher rates of adverse in-hospital outcomes in 9 of 14 examined categories, with OR ranging from 2.88 for cardiac complications to 1.83 for vascular complications and 1.43 for overall complications (all p < 0.05), but not in-hospital mortality (p > 0.05). Conclusions: Patients with valvulopathy treated with RN are generally older and present with more baseline comorbidities. In this population, RN is associated with a higher risk of adverse in-hospital outcomes compared with PN when examining the impact of valvulopathy on such outcomes.