Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jun;11(2):152-8.
doi: 10.1016/j.aju.2013.03.006. Epub 2013 May 3.

The effect of preoperative clinical variables on the 30- and 90-day morbidity and mortality after radical cystectomy: A single-centre study

Khaled Mursi  1 , Hany ElFayoumy  1 , Ismail Saad  1 , Ahmed Tawakol  1 , Hesham Badawy  1
Affiliations

The effect of preoperative clinical variables on the 30- and 90-day morbidity and mortality after radical cystectomy: A single-centre study

Khaled Mursi et al. Arab J Urol. 2013 Jun.

Abstract

Objective: To analyse the effect of preoperative clinical variables and comorbidity on the early, late and cumulative 90-day morbidity and mortality rates, as well as hospital re-admissions, after radical cystectomy (RC), in one centre.

Patients and methods: All patients undergoing RC over a period of 3 months were included. Preoperative investigations included measurements of serum albumin, a complete blood analysis, body mass index (BMI), Charlson comorbidity index (CCI) and the age-adjusted CCI (ACCI). We recorded the length of hospital stay (LOS) and all postoperative events for 90 days, and graded them according to the five-grade modification of the original Clavien system.

Results: In all there were 31 patients undergoing RC (mean age 58.4 years). The mean preoperative serum albumin and haemoglobin level, BMI, CCI and ACCI were 3.82 g/dL, 12.53 g/dL, 29.29 kg/m(2), 3.0 and 4.58, respectively. The mean LOS was 20.03 days; seven patients needed re-admission and three died within the 90 days. There were postoperative complications in 20 patients. The age, CCI and ACCI were significantly associated with complications (P = 0.009, 0.001 and < 0.001, respectively). Preoperative haemoglobin, BMI and smoking had no effect on the morbidity or mortality rate. The LOS increased in older patients (P = 0.031) and those with a higher ACCI (P = 0.042). Postoperative mortality increased among patients with a lower serum albumin level (P = 0.048).

Conclusions: Age, CCI and ACCI are related to early postoperative complications. Older patients and patients with a higher ACCI have a longer LOS. A low preoperative albumin level needs to be evaluated more thoroughly.

Keywords: ACCI, age-adjusted CCI; BMI, body mass index; Bladder cancer; CCI, charlson comorbidity index; Charlson index; Comorbidity; Complications; Cystectomy; Hb, haemoglobin; IQR, interquartile range; LOS, length of hospital stay; RC, radical cystectomy.

PubMed Disclaimer

References

    1. Ploeg M., Aben K.K., Kiemeney L.A. The present and future burden of urinary bladder cancer in the world. World J Urol. 2009;27:289–293. - PMC - PubMed
    1. Babjuk M., Oosterlinck W., Sylvester R., Kaasinen E., Böhle A., Palou-Redorta J. EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder. Eur Urol. 2008;54:303–314. - PubMed
    1. Isbarn H., Jeldres C., Zini L., Perrotte P., Baillargeon-Gagne S., Capitanio U. A population based assessment of perioperative mortality after cystectomy for bladder cancer. J Urol. 2009;182:70–77. - PubMed
    1. Extermann M. Measurement and impact of co-morbidity in older cancer patients. Crit Rev Oncol Hematol. 2000;35:181–200. - PubMed
    1. Charlson M.E., Pompei P., Ales K.L., MacKenzie C.R. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–383. - PubMed

LinkOut - more resources