Background
Methods
N | % | |
---|---|---|
Gender
| ||
Men | 61 | 75.3 |
Women | 20 | 24.7 |
Age (years) , mean (SD)
| 79.2(3.7) | |
Age (years)*
| ||
<77 | 23 | 28.4 |
77-80 | 31 | 38.3 |
>80 | 27 | 33.3 |
BMI, mean (SD)
| 25.5(3.2) | |
Urinary diversion
| ||
Ileal conduit | 39 | 48.1 |
S-pouch | 5 | 6.2 |
Cutaneous ureterostomy | 37 | 45.7 |
pT (TNM system)
| ||
pTis | 12 | 14.8 |
pT1 to pT2b | 28 | 34.6 |
pT3a to pT3b | 29 | 35.8 |
pT4a to pT4b | 12 | 14.8 |
Nodes (TNM system)
| ||
0 | 60 | 74.1 |
1-2 | 21 | 25.9 |
Hospital stay (days), mean (SD)
| 13.0 (7.3) | |
Charlson score
| ||
≤6 | 69 | 85.2 |
>6 | 12 | 14.8 |
Criteria | Requirement |
---|---|
Method of accruing data defined | Prospective or retrospective accrual of data are indicated. |
Duration of follow-up indicated | Report clarifies the time period of postoperative accrual |
of complications such as 30 days or same hospitalization. | |
Outpatient information included | Study indicates that complications first identified following |
discharge are included in the analysis. | |
Definitions of complications provided | Article defines at least one complication with specific inclusion criteria. |
Mortality rate and causes of death listed | The number of patients who died in the postoperative period of study |
are recorded together with cause of death. | |
Morbidity rate and total complications indicated | The number of patients with any complication and the total number |
of complications are recorded. | |
Procedure-specific complications included | |
Severity grade utilized | Any grading system designed to clarify severity of complications |
including “major and minor” is reported. | |
Length-of-stay data | Median or mean length of stay indicated in the study. |
Risk factors included in the analysis | Evidence of risk stratification and method used indicated by study. |
CLAVIEN grade | N | % | N | % | ||
---|---|---|---|---|---|---|
No complication | 29 | 35.8 | ||||
Perioperative morbidity (0-10d) | 35 | 43.2 | 90-day morbidityEmphasis> | 30 | 37 | |
1
|
11
|
13.6
|
15
|
18.6
| ||
Any deviation from the normal postoperative course without the need for pharmacological treatment or surgical, endoscopic, and radiological interventions. Allowed therapeutic regimens are: drugs as antiemetics, antipyretics, analgetics, diuretics, electrolytes, and physiotherapy. This grade also includes wound infections opened at the bedside. | Hyperemesis | 1 | 1.2 | Pneumonia | 2 | 2.4 |
Fever | 7 | 8.4 | Psoas abscess | 1 | 1.2 | |
Ileus | 1 | 1.2 | Wound infection | 11 | 13.6 | |
Pneumonia | 1 | 1.2 | Lympocele | 1 | 1.2 | |
Urine leakage | 1 | 1.2 | ||||
2
|
22
|
27.2
|
4
|
4.8
| ||
Requiring pharmacological treatment with drugs other than such allowed for grade I complications. Blood transfusions and total parenteral nutrition are also included. | Blood transfusion | 21 | 25.9 | Wound dehiscense | 1 | 1.2 |
UTI | 1 | 1.2 | UTI | 3 | 3.6 | |
3
|
1
|
1.2
|
6
|
7.2
| ||
Requiring surgical, endoscopic or radiological intervention | ||||||
3a
|
-
|
-
|
0
|
2
|
2.4
| |
Intervention not under general anesthesia | - | - | 0 | Cardiac arrythmia-pacemaker | 1 | 1.2 |
Obstructive nephropathy | 1 | 1.2 | ||||
3b
|
1
|
1.2
|
4
|
4.8
| ||
Intervention under general anesthesia | Rectal injury, re-operation, colostomy | 1 | 1.2 | Evisceration, re-operation | 1 | 1.2 |
Stricture ileus, re-operation | 2 | 2.4 | ||||
Incisional hernia | 1 | 1.2 | ||||
4
|
1
|
1.2
|
2
|
2.4
| ||
Life-threatening complication (including CNS complications) requiring IC/ICU management | Sepsis | 1 | 1.2 | Myocardial Infarction | 1 | 1.2 |
Sepsis | 1 | 1.2 | ||||
5
|
-
|
-
|
0
|
3
|
3.7
| |
Death of a patient |
Death
|
3
|
3.7
| |||
30-day (sepsis, pneumonia) | 2 | 2.4 | ||||
60-day (evisceration, re-operation | 1 | 1.2 | ||||
90-day
| 0 | 0 |
Statistical analysis
Results
Perioperative morbidity (10 days) | Px² test | ||||
---|---|---|---|---|---|
No | Yes | ||||
N | % | N | % | ||
Gender
| |||||
Male | 36 | 59.0 | 25 | 41.0 | 0.752 |
Female | 11 | 55.0 | 9 | 45.0 | |
Age (years) , mean (SD)
| 79.3(4.0) | 78.9(3.2) | 0.650** | ||
Age (years)
| |||||
<77 | 14 | 60.9 | 9 | 39.1 | 0.895 |
77-80 | 17 | 54.8 | 14 | 45.2 | |
>80 | 16 | 59.3 | 11 | 40.7 | |
BMI, mean (SD)
| 25.6(2.9) | 25.5(3.7) | 0.873** | ||
Urinary diversion
| |||||
Ileal conduit | 22 | 56.4 | 17 | 43.6 | 0.724* |
S-pouch | 4 | 80.0 | 1 | 20.0 | |
Cutaneous ureterostomy | 21 | 56.8 | 16 | 43.2 | |
pT (TNM system)
| |||||
pTis | 3 | 25.0 | 9 | 75.0 | 0.070 |
pT1 to pT2b | 17 | 60.7 | 11 | 39.3 | |
pT3a to pT3b | 18 | 62.1 | 11 | 37.9 | |
pT4a to pT4b | 9 | 75.0 | 3 | 25.0 | |
Nodes (TNM system)
| |||||
0 | 34 | 56.7 | 26 | 43.3 | 0.675 |
1-2 | 13 | 61.9 | 8 | 38.1 | |
Hospital stay, mean (SD)
| 13.7(8.4) | 12.1(5.4) | 0.334** | ||
Charlson score
| |||||
≤6 | 39 | 56.5 | 30 | 43.5 | 0.511 |
>6 | 8 | 66.7 | 4 | 33.3 |
Crude | Adjusted | |||
---|---|---|---|---|
HR (95% CI) ‡ | P | HR (95% CI) | P | |
Gender
| ||||
Male | 1.00* | |||
Female | 0.98 (0.42 - 2.28) | 0.955 | ||
Age (years), mean ± SD
| 1.08 (0.99 - 1.17) | 0.079 | ||
Age (years)
| ||||
<77 | 1.00* | 1.00* | ||
77-80 | 4.12 (1.18 - 14.33) | 0.026 | 4.92 (1.35 - 17.95) | 0.016 |
>80 | 4.04 (1.14 - 14.31) | 0.031 | 5.86 (1.47 - 23.42) | 0.012 |
BMI, mean ± SD
| 1.15 (1.04 - 1.27) | 0.008 | 1.18 (1.04 - 1.34) | 0.011 |
Urinary diversion
| ||||
Ileal conduit | 1.00* | |||
S-pouch | ** | |||
Cutaneous ureterostomy | 1.18 (0.57 - 2.44) | 0.658 | ||
pT (TNM system)
| ||||
pTis | 1.00* | |||
pT1 to pT2b | 0.51 (0.18 - 1.42) | 0.197 | ||
pT3a to pT3b | 0.62 (0.23 - 1.72) | 0.362 | ||
pT4a to pT4b | 0.56 (0.16 - 2) | 0.377 | ||
Nodes (TNM system)
| ||||
0 | 1.00* | |||
1-2 | 1.2 (0.53 - 2.7) | 0.665 | ||
Hospital stay, mean ± SD
| 1.05 (1.02 - 1.09) | 0.002 | 1.06 (1.02 - 1.09) | 0.002 |
Charlson score
| ||||
≤6 | 1.00* | 1.00* | ||
>6 | 2.43 (1.03 - 5.7) | 0.042 | 2.51 (1.06 - 5.94) | 0.037 |
Crude | Adjusted | |||
---|---|---|---|---|
HR (95% CI)‡ | P | HR (95% CI) | P | |
Gender
| ||||
Male | 1.00* | |||
Female | 0.41 (0.12 - 1.4) | 0.155 | ||
Age (years), mean ± SD
| 1 (0.89 - 1.13) | 0.976 | ||
Age (years)
| ||||
<77 | 1.00* | |||
77-80 | 1.57 (0.57 - 4.34) | 0.382 | ||
>80 | 1.06 (0.36 - 3.17) | 0.910 | ||
BMI, mean ± SD
| 0.96 (0.84 - 1.1) | 0.563 | ||
Urinary diversion
| ||||
Ileal conduit | 1.00* | 0.997 | ||
S-pouch | ** | |||
Cutaneous ureterostomy | 1.03 (0.45 - 2.36) | 0.944 | ||
pT (TNM system)
| ||||
pTis | 1.00* | 1.00* | ||
pT1 to pT2b | 3.11 (0.37 - 25.88) | 0.293 | 2.87 (0.35 - 23.9) | 0.329 |
pT3a to pT3b | 5.5 (0.7 - 43.04) | 0.105 | 5.99 (0.76 - 46.95) | 0.088 |
pT4a to pT4b | 9.11 (1.09 - 75.81) | 0.041 | 9.19 (1.10 - 76.58) | 0.040 |
Nodes (TNM system)
| ||||
0 | 1.00* | 1.00* | ||
1-2 | 2.52 (1.10 – 5.75) | 0.028 | 2.4 (1.05 - 5.49) | 0.039 |
Hospital stay. mean ± SD
| 0.99 (0.93 - 1.06) | 0.777 |