Canadian Urological Association journal = Journal de l'Association des urologues du Canada最新文献

Introduction: Radical cystectomy (RC) is associated with high rates of morbidity, prolonged hospital stay, and increased opioid use for postoperative pain management; however, the relationship between postoperative opioid use and length of stay (LOS ) remains uncharacterized. This study serves to investigate the association between postoperative opioid use and length of hospital stay after RC. The relationship between patient and surgical factors on LOS was also characterized.

Methods: We retrospectively reviewed all patients between 2009 and 2019 who underwent RC at our institution. Patient and perioperative variables were analyzed to determine the relationship between postoperative opioid use and LOS using multivariable linear regression analysis.

Results: We identified 240 patients for study inclusion with a median age of 70.0 years. Median LOS was 10.0 days, with median daily mg morphine equivalent use of 57.5 for patients. Daily mg morphine equivalent use was significantly associated with an increased LOS, as were previous pelvic radiation, postoperative ileus, and higher Clavien-Dindo grade complication during admission (all p<0.05). Median LOS increased by one day for each increase of 13.2 daily mg morphine equivalents received.

Conclusions: Increased daily opioid use was associated with increased length of hospital stay after RC. Non-opioid-based pain management approaches may be effective in reducing LOS after RC.

Introduction: Canadian Urological Association (CUA) conferences are held annually across Canada. Guests from across the world attended, contributing to the overall carbon footprint of the conference with their travel and accommodations. This study identified the carbon footprint of each of the 2016 (Vancouver), 2018 (Halifax), and 2019 (Quebec City) CUA conferences to investigate their carbon footprint and help determine the most eco-friendly location to hold future conferences.

Methods: Registrant home institution was used to estimate the distance and method of transportation of attendee travel. Carbon footprint was calculated using an online calculator in tons of CO₂ equivalents (tCO₂). Total attendees, number of attendees driving, number of attendees flying, mean distance travelled per attendee, total carbon footprint, and average carbon footprint per attendee were calculated for each conference. Mean carbon footprint, and mean distance travelled were compared using a Brown-Forsythe ANOVA test, with Dunnett's T3 multiple comparisons test (α=0.05).

Results: Vancouver had the largest number of attendees (n=473; 407 flying, 66 driving), followed by Halifax (n=382; 331 flying, 51 driving), and Quebec City (n=362; 265 flying, 97 driving). The mean distance attendees travelled was greatest for the Vancouver CUA (6041 km/roundtrip) compared to Quebec City (3096 km/roundtrip, p<0.0001) and Halifax (2985 km/roundtrip, p<0.0001). There was no difference in mean distance travelled between Halifax and Quebec City (p=0.95). The highest total carbon footprint was seen in Vancouver (tCO₂=447.76), followed by Quebec City (tCO₂=217.04) and Halifax (tCO₂=182.22). The average footprint per attendee was significantly higher in Vancouver (mean tCO₂=1.08) compared to both Quebec City (mean tCO₂=0.62, p<0.0001) and Halifax (mean tCO₂=0.52, p<0.0001). There was no difference in the average footprint between Halifax and Quebec City (p=0.63).

Conclusions: The estimated emissions associated with the Vancouver CUA conference is greater than both the Halifax and Quebec City locations combined. In-person conferences provide several benefits to the urological community. Incorporating environmental considerations into conference planning, such as conference location, could reduce the CUA conference's overall carbon footprint, mitigating the contribution to rising temperatures and negative health outcomes.