| Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | European Journal of Surgical Oncology | ||||
| Publisher: | Elsevier | ||||
| Place of Publication: | OXFORD | ||||
| Volume: | 47 | ||||
| Number of Issue or Book Chapter: | 5 | ||||
| Page Range: | pp. 1163-1171 | ||||
| Date: | 2021 | ||||
| Institutions: | Medicine > Lehrstuhl für Urologie Medicine > Lehrstuhl für experimentelle Medizin und Therapieverfahren | ||||
| Identification Number: |
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| Keywords: | RECOMMENDATIONS; COMORBIDITY; OUTCOMES; Urinary bladder; Clavien Dindo classification; Cumulative morbidity; Postoperative complications; Comprehensive complication index; Radical cystectomy | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 55890 |
Web of ScienceAbstract
Objective: To assess the true cumulative morbidity after RC by implementing the Comprehensive Complication Index (CCI) over a 90-day period, since recent evidence suggests underreporting of the cumulative morbidity after radical cystectomy (RC) with inconsistent complication rates when reported with conventional reporting systems. Patients and methods: Medical records of 433 patients with bladder ...
Abstract
Objective: To assess the true cumulative morbidity after RC by implementing the Comprehensive Complication Index (CCI) over a 90-day period, since recent evidence suggests underreporting of the cumulative morbidity after radical cystectomy (RC) with inconsistent complication rates when reported with conventional reporting systems. Patients and methods: Medical records of 433 patients with bladder cancer who underwent RC were retrospectively reviewed over a 90-day period. Clinical variables were assessed and complications were graded by the Clavien-Dindo Classification (CDC). The resulting 30- and 90-day CCI-scores were calculated and compared for each patient. Multivariable regression models for developing at least one severe (>= CDC IIIb) complication were designed. Results: Overall, 848 complications were recorded in 371 patients (85.7%). Severe complications occurred in 130 patients (30%) and the cumulative morbidity corresponded to the level of a severe complication in 159 patients (36.7%), meaning an upgrade in 6.7% of patients compared to the CDC. The 90-day CCI (24.2 (median, IQR 20.9-39.7)) was higher than the 30-day CCI (22.6 (median, IQR 8.7-39.7)), (p < 0.001). Comorbidity indices (ASA, ACE 27), BMI, and incontinent urinary diversions were independent risk factors for suffering a severe complication within 90 days post-surgery. Conclusion: The cumulative morbidity (CCI) after RC seems to be higher than previously reported with CDC, especially over a 90-day period. The CCI is an appropriate assessment-tool with an upgrade in morbidity in a significant proportion of patients when compared to the CDC. BMI, several comorbidity indices, and incontinent urinary diversions are independent risk factors for suffering a severe complication after RC. (C) 2020 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
Metadata last modified: 29 Feb 2024 12:18
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