Patient frailty predicts worse perioperative outcomes and higher cost after radical cystectomy worse radical cystectomy outcomes in frails
Palumbo C., Knipper S., Pecoraro A., Rosiello G., Luzzago S., Deuker M., Tian Z., Shariat Sh., Simeone C., Briganti A., Saad F., Berruti A., Antonelli A., Karakiewicz P. I.
Surgical Oncology
Vol.32, P. 8-13
Опубликовано: 2020
Тип ресурса: Статья
DOI:10.1016/j.suronc.2019.10.014
Аннотация:
Background: Relatively few studies investigated the importance of frailty in radical cystectomy (RC) patients. We tested the ability of frailty, using the Johns Hopkins Adjusted Clinical Groups indicator, to predict early perioperative outcomes after RC. Methods: RC patients were identified within the National Inpatient Sample database (2000–2015). The effect of frailty, age and Charlson Comorbidity Index were tested in five separate multivariable models predicting: (1) complications, (2) failure to rescue (FTR), (3) in-hospital mortality, (4) length of stay (LOS) and (5) total hospital charges (THCs). All models were weighted and adjusted for clustering, as well as all available patient and hospital characteristics. Results: Of 23,967 RC patients, 5833 (24.3[%]) were frail, 7721 (32.2[%]) were aged ≥75 years and 2832 (11.8[%]) had CCI ≥2. Frailty, age ≥75 years and CCI ≥2 were non-overlapping in 86.3[%] of the cohort. Any two or three of these features were recorded in 12.4 and 1.3[%], respecti
Ключевые слова:
Complications; Frailty; Radical cystectomy
adult; aged; Article; Charlson Comorbidity Index; cohort analysis; cystectomy; female; frailty; health care cost; hospital charge; hospital mortality; human; ileal conduit; laparoscopic surgery; length of stay; major clinical study; male; minimally invasive surgery; perioperative period; postoperative complication; prediction; priority journal; robot assisted surgery
Язык текста: Английский
ISSN: 1879-3320
Palumbo C.
Knipper S.
Pecoraro A.
Rosiello G.
Luzzago S.
Deuker M.
Tian Z.
Shariat Sh. Sharokh 1973-
Simeone C.
Briganti A.
Saad F.
Berruti A.
Antonelli A.
Karakiewicz P. I.
Палумбо C.
Книппер С.
Пеcораро А.
Росиелло Г.
Луззаго С.
Деукер М.
Тиан З.
Шариат Ш. Шарох 1973-
Симеоне C.
Бриганти А.
Саад Ф.
Беррути А.
Антонелли А.
Каракиеwиcз П. И.
Patient frailty predicts worse perioperative outcomes and higher cost after radical cystectomy worse radical cystectomy outcomes in frails
Текст визуальный непосредственный
Surgical Oncology
Elsevier Science Publisher B.V.
Vol.32 P. 8-13
2020
Статья
Complications Frailty Radical cystectomy
adult aged Article Charlson Comorbidity Index cohort analysis cystectomy female frailty health care cost hospital charge hospital mortality human ileal conduit laparoscopic surgery length of stay major clinical study male minimally invasive surgery perioperative period postoperative complication prediction priority journal robot assisted surgery
Background: Relatively few studies investigated the importance of frailty in radical cystectomy (RC) patients. We tested the ability of frailty, using the Johns Hopkins Adjusted Clinical Groups indicator, to predict early perioperative outcomes after RC. Methods: RC patients were identified within the National Inpatient Sample database (2000–2015). The effect of frailty, age and Charlson Comorbidity Index were tested in five separate multivariable models predicting: (1) complications, (2) failure to rescue (FTR), (3) in-hospital mortality, (4) length of stay (LOS) and (5) total hospital charges (THCs). All models were weighted and adjusted for clustering, as well as all available patient and hospital characteristics. Results: Of 23,967 RC patients, 5833 (24.3[%]) were frail, 7721 (32.2[%]) were aged ≥75 years and 2832 (11.8[%]) had CCI ≥2. Frailty, age ≥75 years and CCI ≥2 were non-overlapping in 86.3[%] of the cohort. Any two or three of these features were recorded in 12.4 and 1.3[%], respecti