The relationship of Charlson comorbidity index and postoperative complications in elderly patients after partial or radical nephrectomy

  • E. Becher
  • P. García Marchinena
  • J. Jaunarena
  • D. Santillán
  • L. Pérez
  • B. Boietti
  • A. Jurado
  • G. Gueglio
Keywords: Outcomes for partial/radical nephrectomy, Charlson comorbidity index, Postoperative complications, Active surveillance, Kidney cancer on the elderly

Abstract

Objectives: To compare preoperative Charlson comorbidity Index (CCI) and postoperative complications after oncologic kidney surgery in patients aged 70 or older. To compare CCI and need for interdisciplinary evaluation, consults to the emergency department and need of readmission are secondary objectives.
Patients and methods: This is a retrospective cohort study. Patients aged 70 or older who underwent partial or radical nephrectomy were collected from an institutional database. Period: February 2012–June 2014. Association between CCI and complications was estimated using Chi2.
Results: Final population: 143 (male: 65%). Age median was 75. Minor postoperative complications were 33.88% (n = 41) for patients CCI ≤ 4 versus 9.09% (n = 2) for patients CCI > 4 (p > 0.05), and major postoperative complications were 9.91% (n = 12) versus 45.45% (n = 10), respectively (p < 0.01). Interdisciplinary evaluation was required for 30.6% (n = 37) of patients CCI ≤ 4 versus 59% (n = 13) of patients CCI > 4 (p = 0.01). Readmission was needed for 9.09% (n = 11) and 40.1% (n = 11) respectively (p < 0.01).
Conclusions: Patients with high comorbidity presented more major postoperative complications. These patients also required more interdisciplinary evaluation after surgery. A higher CCI was not associated with further consults to the emergency department or readmission.

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