Haas, Maximilian and Huber, Toni and Pickl, Christoph and van Rhijn, Bas W. G. and Guzvic, Miodrag and Gierth, Michael and Breyer, Johannes and Burger, Maximilian and Mayr, Roman (2021) The comprehensive complication index is associated with a significant increase in complication severity between 30 and 90 days after radical cystectomy for bladder cancer. EJSO, 47 (5). pp. 1163-1171. ISSN 0748-7983, 1532-2157
Full text not available from this repository. (Request a copy)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.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | RECOMMENDATIONS; COMORBIDITY; OUTCOMES; Urinary bladder; Clavien Dindo classification; Cumulative morbidity; Postoperative complications; Comprehensive complication index; Radical cystectomy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie Medicine > Lehrstuhl für experimentelle Medizin und Therapieverfahren |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 29 Aug 2022 12:58 |
| Last Modified: | 29 Aug 2022 12:58 |
| URI: | https://pred.uni-regensburg.de/id/eprint/46479 |
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