Postoperative complications and 90-day mortality in radical cystectomy in high-risk patients: A monocentric retrospective observational study

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Abstract

Aim: Assessing the incidence of immediate postoperative complications and 90-day mortality in high-risk patients who have undergone radical cystectomy; evaluating the correlation between preoperative conditions and surgery outcomes. Materials and methods: This is a monocentric retrospective observational study in which data of 65 patients have been analyzed.High-risk criteria: (a) Age ≥75 years, (b) obesity, (c) age-adjusted Charlson Comorbidity Index ≥8, (d) anemic status, and (e) pT ≥3. More than 50% of patients had two or more “high-risk” indicators. Postoperative complications were assessed through Clavien–Dindo classification.Results: Average age of patients was 70.4 years, average age-adjusted Charlson Comorbidity Index was 5.8, and average body mass index was 27.5. In 28% of patients, no complications arose, while in 46% grades I–II according to Clavien–Dindo occurred, in 23% grades III–IV occurred, and in 3% of the patients, death arose in the immediate postoperative period (grade V). Overall, 90-day mortality rate after surgery was 12.3%. The age ≥75years and an age-adjusted Charlson Comorbidity Index score ≥8 have shown to be risk factors for the onset of severe complications (odds ratio = 3.54, p = 0.028 and odds ratio = 4.7, p = 0.026), while preoperative anemic status was for complications in general (odds ratio = 4.1, p = 0.015). No analyzed parameter was a predictor of 90-day mortality (p > 0.05).Conclusion: Immediate postoperative complications and 90-day mortality in radical cystectomy in high-risk patients remain significant, but still in line with the data in the literature on comparable populations. Some of the preoperative parameters were able to predict the outcomes of the intervention with regard to the onset of complications but not to the 90-day mortality.
Lingua originaleEnglish
pagine (da-a)111-117
Numero di pagine7
RivistaUrologia
Volume85
Stato di pubblicazionePublished - 2018

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Cystectomy
Observational Studies
Retrospective Studies
Mortality
Comorbidity
Odds Ratio
Postoperative Period
Body Mass Index
Obesity
Incidence
Population

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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@article{a841360be39c4f09aa19fecc6c7c6b89,
title = "Postoperative complications and 90-day mortality in radical cystectomy in high-risk patients: A monocentric retrospective observational study",
abstract = "Aim: Assessing the incidence of immediate postoperative complications and 90-day mortality in high-risk patients who have undergone radical cystectomy; evaluating the correlation between preoperative conditions and surgery outcomes. Materials and methods: This is a monocentric retrospective observational study in which data of 65 patients have been analyzed.High-risk criteria: (a) Age ≥75 years, (b) obesity, (c) age-adjusted Charlson Comorbidity Index ≥8, (d) anemic status, and (e) pT ≥3. More than 50{\%} of patients had two or more “high-risk” indicators. Postoperative complications were assessed through Clavien–Dindo classification.Results: Average age of patients was 70.4 years, average age-adjusted Charlson Comorbidity Index was 5.8, and average body mass index was 27.5. In 28{\%} of patients, no complications arose, while in 46{\%} grades I–II according to Clavien–Dindo occurred, in 23{\%} grades III–IV occurred, and in 3{\%} of the patients, death arose in the immediate postoperative period (grade V). Overall, 90-day mortality rate after surgery was 12.3{\%}. The age ≥75years and an age-adjusted Charlson Comorbidity Index score ≥8 have shown to be risk factors for the onset of severe complications (odds ratio = 3.54, p = 0.028 and odds ratio = 4.7, p = 0.026), while preoperative anemic status was for complications in general (odds ratio = 4.1, p = 0.015). No analyzed parameter was a predictor of 90-day mortality (p > 0.05).Conclusion: Immediate postoperative complications and 90-day mortality in radical cystectomy in high-risk patients remain significant, but still in line with the data in the literature on comparable populations. Some of the preoperative parameters were able to predict the outcomes of the intervention with regard to the onset of complications but not to the 90-day mortality.",
author = "Alchiede Simonato and Carlo Pavone and Dario Fontana",
year = "2018",
language = "English",
volume = "85",
pages = "111--117",
journal = "Urologia",
issn = "0391-5603",
publisher = "Wichtig Publishing",

}

TY - JOUR

T1 - Postoperative complications and 90-day mortality in radical cystectomy in high-risk patients: A monocentric retrospective observational study

AU - Simonato, Alchiede

AU - Pavone, Carlo

AU - Fontana, Dario

PY - 2018

Y1 - 2018

N2 - Aim: Assessing the incidence of immediate postoperative complications and 90-day mortality in high-risk patients who have undergone radical cystectomy; evaluating the correlation between preoperative conditions and surgery outcomes. Materials and methods: This is a monocentric retrospective observational study in which data of 65 patients have been analyzed.High-risk criteria: (a) Age ≥75 years, (b) obesity, (c) age-adjusted Charlson Comorbidity Index ≥8, (d) anemic status, and (e) pT ≥3. More than 50% of patients had two or more “high-risk” indicators. Postoperative complications were assessed through Clavien–Dindo classification.Results: Average age of patients was 70.4 years, average age-adjusted Charlson Comorbidity Index was 5.8, and average body mass index was 27.5. In 28% of patients, no complications arose, while in 46% grades I–II according to Clavien–Dindo occurred, in 23% grades III–IV occurred, and in 3% of the patients, death arose in the immediate postoperative period (grade V). Overall, 90-day mortality rate after surgery was 12.3%. The age ≥75years and an age-adjusted Charlson Comorbidity Index score ≥8 have shown to be risk factors for the onset of severe complications (odds ratio = 3.54, p = 0.028 and odds ratio = 4.7, p = 0.026), while preoperative anemic status was for complications in general (odds ratio = 4.1, p = 0.015). No analyzed parameter was a predictor of 90-day mortality (p > 0.05).Conclusion: Immediate postoperative complications and 90-day mortality in radical cystectomy in high-risk patients remain significant, but still in line with the data in the literature on comparable populations. Some of the preoperative parameters were able to predict the outcomes of the intervention with regard to the onset of complications but not to the 90-day mortality.

AB - Aim: Assessing the incidence of immediate postoperative complications and 90-day mortality in high-risk patients who have undergone radical cystectomy; evaluating the correlation between preoperative conditions and surgery outcomes. Materials and methods: This is a monocentric retrospective observational study in which data of 65 patients have been analyzed.High-risk criteria: (a) Age ≥75 years, (b) obesity, (c) age-adjusted Charlson Comorbidity Index ≥8, (d) anemic status, and (e) pT ≥3. More than 50% of patients had two or more “high-risk” indicators. Postoperative complications were assessed through Clavien–Dindo classification.Results: Average age of patients was 70.4 years, average age-adjusted Charlson Comorbidity Index was 5.8, and average body mass index was 27.5. In 28% of patients, no complications arose, while in 46% grades I–II according to Clavien–Dindo occurred, in 23% grades III–IV occurred, and in 3% of the patients, death arose in the immediate postoperative period (grade V). Overall, 90-day mortality rate after surgery was 12.3%. The age ≥75years and an age-adjusted Charlson Comorbidity Index score ≥8 have shown to be risk factors for the onset of severe complications (odds ratio = 3.54, p = 0.028 and odds ratio = 4.7, p = 0.026), while preoperative anemic status was for complications in general (odds ratio = 4.1, p = 0.015). No analyzed parameter was a predictor of 90-day mortality (p > 0.05).Conclusion: Immediate postoperative complications and 90-day mortality in radical cystectomy in high-risk patients remain significant, but still in line with the data in the literature on comparable populations. Some of the preoperative parameters were able to predict the outcomes of the intervention with regard to the onset of complications but not to the 90-day mortality.

UR - http://hdl.handle.net/10447/280954

M3 - Article

VL - 85

SP - 111

EP - 117

JO - Urologia

JF - Urologia

SN - 0391-5603

ER -