Charlson comorbidity index assists in outcome prediction after Robotic Assisted Radical Cystectomy (RARC) and intracorporeal reconstruction for bladder cancer
BAUS ePoster online library. Ridgway A. 06/22/21; 319008; p10-19
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Alexander Ridgway
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Abstract
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Introduction
Robotic assisted radical cystectomy and intra-corporeal urinary diversion (RARC-ICUD) can be associated with significant morbidity. The objective of this study was to investigate whether pre-operative comorbidity status measured by the Charlson Comorbidity Index (CCI) predicts for postoperative complications and length of stay (LOS) in patients undergoing RARC-ICUD.
Materials & Methods
A retrospective study of a prospectively maintained database of consecutive patients who underwent RARC-ICUD at a tertiary referral centre between 2011-2019 was performed. CCI was analysed in relationship to peri-operative outcomes including: post-operative length of stay, Clavien-Dindo complications and survival.
Results
428 patients underwent RARC-ICUD over the study period; of these 78 were excluded from the analysis as a CCI score was not calculated. In the cohort analysed (n=350), median age was 69 years (R 18- 89), 33% underwent neo-adjuvant chemotherapy and median length of stay after surgery was 7 days (Range 3- 77). Multivariate analysis demonstrated a higher CCI pre-operative score was associated with a higher rate of complications at 30 and 90 days post-surgery, (IRR 1.151, p=0.022). Multivariate analysis demonstrated that a higher CCI score was associated with a longer length of stay, Incident Rate Ratio (IRR) 1.047, p=0.05. CCI did not predicted readmission or mortality rates after surgery.
Conclusions
This study shows the CCI score is a simple, reliable and cost-effective way of identifying patients at increased risk of complication and prolonged length of stay after RARC-ICUD. Surgeons performing Radical Cystectomy should consider utilising it to improve pre-operative patient risk stratification prior to RARC-ICUD.
Robotic assisted radical cystectomy and intra-corporeal urinary diversion (RARC-ICUD) can be associated with significant morbidity. The objective of this study was to investigate whether pre-operative comorbidity status measured by the Charlson Comorbidity Index (CCI) predicts for postoperative complications and length of stay (LOS) in patients undergoing RARC-ICUD.
Materials & Methods
A retrospective study of a prospectively maintained database of consecutive patients who underwent RARC-ICUD at a tertiary referral centre between 2011-2019 was performed. CCI was analysed in relationship to peri-operative outcomes including: post-operative length of stay, Clavien-Dindo complications and survival.
Results
428 patients underwent RARC-ICUD over the study period; of these 78 were excluded from the analysis as a CCI score was not calculated. In the cohort analysed (n=350), median age was 69 years (R 18- 89), 33% underwent neo-adjuvant chemotherapy and median length of stay after surgery was 7 days (Range 3- 77). Multivariate analysis demonstrated a higher CCI pre-operative score was associated with a higher rate of complications at 30 and 90 days post-surgery, (IRR 1.151, p=0.022). Multivariate analysis demonstrated that a higher CCI score was associated with a longer length of stay, Incident Rate Ratio (IRR) 1.047, p=0.05. CCI did not predicted readmission or mortality rates after surgery.
Conclusions
This study shows the CCI score is a simple, reliable and cost-effective way of identifying patients at increased risk of complication and prolonged length of stay after RARC-ICUD. Surgeons performing Radical Cystectomy should consider utilising it to improve pre-operative patient risk stratification prior to RARC-ICUD.
Introduction
Robotic assisted radical cystectomy and intra-corporeal urinary diversion (RARC-ICUD) can be associated with significant morbidity. The objective of this study was to investigate whether pre-operative comorbidity status measured by the Charlson Comorbidity Index (CCI) predicts for postoperative complications and length of stay (LOS) in patients undergoing RARC-ICUD.
Materials & Methods
A retrospective study of a prospectively maintained database of consecutive patients who underwent RARC-ICUD at a tertiary referral centre between 2011-2019 was performed. CCI was analysed in relationship to peri-operative outcomes including: post-operative length of stay, Clavien-Dindo complications and survival.
Results
428 patients underwent RARC-ICUD over the study period; of these 78 were excluded from the analysis as a CCI score was not calculated. In the cohort analysed (n=350), median age was 69 years (R 18- 89), 33% underwent neo-adjuvant chemotherapy and median length of stay after surgery was 7 days (Range 3- 77). Multivariate analysis demonstrated a higher CCI pre-operative score was associated with a higher rate of complications at 30 and 90 days post-surgery, (IRR 1.151, p=0.022). Multivariate analysis demonstrated that a higher CCI score was associated with a longer length of stay, Incident Rate Ratio (IRR) 1.047, p=0.05. CCI did not predicted readmission or mortality rates after surgery.
Conclusions
This study shows the CCI score is a simple, reliable and cost-effective way of identifying patients at increased risk of complication and prolonged length of stay after RARC-ICUD. Surgeons performing Radical Cystectomy should consider utilising it to improve pre-operative patient risk stratification prior to RARC-ICUD.
Robotic assisted radical cystectomy and intra-corporeal urinary diversion (RARC-ICUD) can be associated with significant morbidity. The objective of this study was to investigate whether pre-operative comorbidity status measured by the Charlson Comorbidity Index (CCI) predicts for postoperative complications and length of stay (LOS) in patients undergoing RARC-ICUD.
Materials & Methods
A retrospective study of a prospectively maintained database of consecutive patients who underwent RARC-ICUD at a tertiary referral centre between 2011-2019 was performed. CCI was analysed in relationship to peri-operative outcomes including: post-operative length of stay, Clavien-Dindo complications and survival.
Results
428 patients underwent RARC-ICUD over the study period; of these 78 were excluded from the analysis as a CCI score was not calculated. In the cohort analysed (n=350), median age was 69 years (R 18- 89), 33% underwent neo-adjuvant chemotherapy and median length of stay after surgery was 7 days (Range 3- 77). Multivariate analysis demonstrated a higher CCI pre-operative score was associated with a higher rate of complications at 30 and 90 days post-surgery, (IRR 1.151, p=0.022). Multivariate analysis demonstrated that a higher CCI score was associated with a longer length of stay, Incident Rate Ratio (IRR) 1.047, p=0.05. CCI did not predicted readmission or mortality rates after surgery.
Conclusions
This study shows the CCI score is a simple, reliable and cost-effective way of identifying patients at increased risk of complication and prolonged length of stay after RARC-ICUD. Surgeons performing Radical Cystectomy should consider utilising it to improve pre-operative patient risk stratification prior to RARC-ICUD.
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