All cause 90-day mortality associated with TUR-P procedure: a Swedish quality register-based study (2013–2022)

Prostatic hyperplasia is among the most common urological conditions in ageing men, and transurethral resection of the prostate (TUR-P) has long been the standard surgical treatment. The perioperative mortality rate (POMR) is an important quality indicator for surgical care, yet contemporary national Swedish POMR data associated with TUR-P is lacking. AIMS: The primary aim was to assess all-cause mortality up to 90-days following TUR-P in Sweden 2013-2022 and whether there was any temporal trend in POMR. The secondary aim was to assess the impact of patients' characteristics (age, ASA class and indication). MATERIAL AND METHODS: This was an observational, register-based cohort study using data from the Swedish-Perioperative-Register (SPOR). A total of 14,052 TUR-P procedures (KED22) for benign prostatic hyperplasia or prostate cancer were included. Descriptive statistics, ANOVA, chi-square test, and multivariable-logistic regression were applied. RESULTS: A total of 10 patients died within 30-days (0.07%) and 56 within 90-days (0.4%). No difference in annual POMR was seen over the study-period. Increasing age, higher ASA-class and cancer indication were the only independent predictors of 90-day mortality. Patients aged above 80-years had an OR of 7.9 (95% confidence interval [CI]: 2.2-42.3), ASA 4 had an OR of 12.6 (95% CI: 1.7-94.3), and cancer diagnosis had an OR of 4.4 (95% CI: 2.5-7.9) in the multivariable logistic regression. CONCLUSIONS: POMR following TUR-P in Sweden is low and numerically similar to age-adjusted background mortality in the Swedish population up to the age of 70-years. High age, ASA-class and cancer diagnosis are the strongest predictors of postoperative mortality.