The comprehensive complication index is more sensitive than the Clavien–Dindo classification for grading complications in elderly patients after radical cystectomy and pelvic lymph node dissection: Implementing the European Association of Urology guideline
ObjectivesLack of assessment of 90-d perioperative morbidity in elderly patients after radical cystectomy and pelvic lymph node dissection (PLND) using a standard reporting methodology, and the Clavien–Dindo classification (CDC) does not accurately reflect the burden of complications. We aim to repo...
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| Format: | Article |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.1002110/full |
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| author | Haiwen Huang Haiwen Huang Haiwen Huang Zhenan Zhang Zhenan Zhang Zhenan Zhang Han Hao Han Hao Han Hao Haixin Wang Meixia Shang Zhijun Xi Zhijun Xi Zhijun Xi |
| author_facet | Haiwen Huang Haiwen Huang Haiwen Huang Zhenan Zhang Zhenan Zhang Zhenan Zhang Han Hao Han Hao Han Hao Haixin Wang Meixia Shang Zhijun Xi Zhijun Xi Zhijun Xi |
| author_sort | Haiwen Huang |
| collection | DOAJ |
| description | ObjectivesLack of assessment of 90-d perioperative morbidity in elderly patients after radical cystectomy and pelvic lymph node dissection (PLND) using a standard reporting methodology, and the Clavien–Dindo classification (CDC) does not accurately reflect the burden of complications. We aim to report the 90-d complications of elderly patients after radical cystectomy, and to compare the validity of the Comprehensive Complication Index (CCI) and CDC.MethodsRetrospective review of 280 patients aged ≥75 years who received radical cystectomy between 2006 and 2021. The 90-d complications of elderly patients after radical cystectomy were reported by implementing the EAU criteria. The CDC and CCI were both used for grading complications. The Spearman rank correlation coefficient was used to estimate the correlation between postoperative stay and CDC/CCI. Logistic regression was used to identify the risk factors for major complications. The sample size for a fictive superiority trial was calculated for different endpoints.ResultsA total of 225 (80.36%) patients suffered from 528 complications. The cumulative CCI had a more accurate prediction of postoperative stay than the CDC (r = 0.378, p < 0.001 vs. r = 0.349, p < 0.001). The need for sample size could decrease when CCI was used for the primary endpoint. More risk factors for major complications were identified when CCI ≥33.7 was defined as the endpoint of major complications.ConclusionCCI is better than CDC for grading the severity of complications in elderly patients after radical cystectomy and PLND. |
| first_indexed | 2024-04-12T16:15:13Z |
| format | Article |
| id | doaj.art-201b564a0fc44ce9aac30d8c4f399111 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-12T16:15:13Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-201b564a0fc44ce9aac30d8c4f3991112022-12-22T03:25:45ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-10-011210.3389/fonc.2022.10021101002110The comprehensive complication index is more sensitive than the Clavien–Dindo classification for grading complications in elderly patients after radical cystectomy and pelvic lymph node dissection: Implementing the European Association of Urology guidelineHaiwen Huang0Haiwen Huang1Haiwen Huang2Zhenan Zhang3Zhenan Zhang4Zhenan Zhang5Han Hao6Han Hao7Han Hao8Haixin Wang9Meixia Shang10Zhijun Xi11Zhijun Xi12Zhijun Xi13Department of Urology, Peking University First Hospital, Beijing, ChinaInstitute of Urology, Peking University, National Urological Cancer Center, Beijing, ChinaInstitute of Urology, National Research Center for Genitourinary Oncology, Beijing, ChinaDepartment of Urology, Peking University First Hospital, Beijing, ChinaInstitute of Urology, Peking University, National Urological Cancer Center, Beijing, ChinaInstitute of Urology, National Research Center for Genitourinary Oncology, Beijing, ChinaDepartment of Urology, Peking University First Hospital, Beijing, ChinaInstitute of Urology, Peking University, National Urological Cancer Center, Beijing, ChinaInstitute of Urology, National Research Center for Genitourinary Oncology, Beijing, ChinaDepartment of Urology, Yankuang New Journey General Hospital, Zoucheng, ChinaDepartment of Medical Statistics, Peking University First Hospital, Beijing, ChinaDepartment of Urology, Peking University First Hospital, Beijing, ChinaInstitute of Urology, Peking University, National Urological Cancer Center, Beijing, ChinaInstitute of Urology, National Research Center for Genitourinary Oncology, Beijing, ChinaObjectivesLack of assessment of 90-d perioperative morbidity in elderly patients after radical cystectomy and pelvic lymph node dissection (PLND) using a standard reporting methodology, and the Clavien–Dindo classification (CDC) does not accurately reflect the burden of complications. We aim to report the 90-d complications of elderly patients after radical cystectomy, and to compare the validity of the Comprehensive Complication Index (CCI) and CDC.MethodsRetrospective review of 280 patients aged ≥75 years who received radical cystectomy between 2006 and 2021. The 90-d complications of elderly patients after radical cystectomy were reported by implementing the EAU criteria. The CDC and CCI were both used for grading complications. The Spearman rank correlation coefficient was used to estimate the correlation between postoperative stay and CDC/CCI. Logistic regression was used to identify the risk factors for major complications. The sample size for a fictive superiority trial was calculated for different endpoints.ResultsA total of 225 (80.36%) patients suffered from 528 complications. The cumulative CCI had a more accurate prediction of postoperative stay than the CDC (r = 0.378, p < 0.001 vs. r = 0.349, p < 0.001). The need for sample size could decrease when CCI was used for the primary endpoint. More risk factors for major complications were identified when CCI ≥33.7 was defined as the endpoint of major complications.ConclusionCCI is better than CDC for grading the severity of complications in elderly patients after radical cystectomy and PLND.https://www.frontiersin.org/articles/10.3389/fonc.2022.1002110/fullelderly patientradical cystectomycomplicationsEAU guidelinescomprehensive complication index |
| spellingShingle | Haiwen Huang Haiwen Huang Haiwen Huang Zhenan Zhang Zhenan Zhang Zhenan Zhang Han Hao Han Hao Han Hao Haixin Wang Meixia Shang Zhijun Xi Zhijun Xi Zhijun Xi The comprehensive complication index is more sensitive than the Clavien–Dindo classification for grading complications in elderly patients after radical cystectomy and pelvic lymph node dissection: Implementing the European Association of Urology guideline Frontiers in Oncology elderly patient radical cystectomy complications EAU guidelines comprehensive complication index |
| title | The comprehensive complication index is more sensitive than the Clavien–Dindo classification for grading complications in elderly patients after radical cystectomy and pelvic lymph node dissection: Implementing the European Association of Urology guideline |
| title_full | The comprehensive complication index is more sensitive than the Clavien–Dindo classification for grading complications in elderly patients after radical cystectomy and pelvic lymph node dissection: Implementing the European Association of Urology guideline |
| title_fullStr | The comprehensive complication index is more sensitive than the Clavien–Dindo classification for grading complications in elderly patients after radical cystectomy and pelvic lymph node dissection: Implementing the European Association of Urology guideline |
| title_full_unstemmed | The comprehensive complication index is more sensitive than the Clavien–Dindo classification for grading complications in elderly patients after radical cystectomy and pelvic lymph node dissection: Implementing the European Association of Urology guideline |
| title_short | The comprehensive complication index is more sensitive than the Clavien–Dindo classification for grading complications in elderly patients after radical cystectomy and pelvic lymph node dissection: Implementing the European Association of Urology guideline |
| title_sort | comprehensive complication index is more sensitive than the clavien dindo classification for grading complications in elderly patients after radical cystectomy and pelvic lymph node dissection implementing the european association of urology guideline |
| topic | elderly patient radical cystectomy complications EAU guidelines comprehensive complication index |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.1002110/full |
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