Correlation between organ-specific co-morbidities and complications in bladder cancer patients undergoing radical cystectomy

TY - JOUR

T1 - Correlation between organ-specific co-morbidities and complications in bladder cancer patients undergoing radical cystectomy

AU - Elmussareh, Muhammad

AU - Simonsen, Pia Carstensen

AU - Young, Matthew

AU - Kingo, Pernille Skjold

AU - Jakobsen, Jakob Kristian

AU - Jensen, Jørgen Bjerggaard

PY - 2018

Y1 - 2018

N2 - OBJECTIVE: To evaluate the association between patients' organ-specific co-morbidities and post-operative complications following radical cystectomy for bladder cancer.PATIENTS AND METHODS: All patients who underwent radical cystectomy at Aarhus University Hospital during the period from January 2006 to February 2014 were included retrospectively. A total of 40 comorbidities and 59 complications were registered meticulously. Univariate and multivariate analyses were used to detect associations between the individual comorbidities and specific post-operative complications.RESULTS: Ninety-two per cent (575/625) of patients experienced one or more complications following radical cystectomy. Clavien-Dindo grade 3-5 complications were observed in 40.8% of patients, and 6.2% had severe complications (Clavien-Dindo grade 4-5). The mortality rate was 2.2%. High BM, previous myocardial infarction and chronic obstructive pulmonary disease were noted to be associated with moderate-to-severe post-operative complications (Clavien-Dindo grade 3-5), while diabetes and lymphoproliferative disorders were significantly associated with severe complications (Clavien-Dindo grade 4-5).CONCLUSION: This study demonstrates that overall complications to radical cystectomy are high (92%). The associations between specific comorbidities and complications need to be further investigated in order to evaluate whether pre-operative assessment can be more optimally used in a prevention strategy tailored to the individual patient.

AB - OBJECTIVE: To evaluate the association between patients' organ-specific co-morbidities and post-operative complications following radical cystectomy for bladder cancer.PATIENTS AND METHODS: All patients who underwent radical cystectomy at Aarhus University Hospital during the period from January 2006 to February 2014 were included retrospectively. A total of 40 comorbidities and 59 complications were registered meticulously. Univariate and multivariate analyses were used to detect associations between the individual comorbidities and specific post-operative complications.RESULTS: Ninety-two per cent (575/625) of patients experienced one or more complications following radical cystectomy. Clavien-Dindo grade 3-5 complications were observed in 40.8% of patients, and 6.2% had severe complications (Clavien-Dindo grade 4-5). The mortality rate was 2.2%. High BM, previous myocardial infarction and chronic obstructive pulmonary disease were noted to be associated with moderate-to-severe post-operative complications (Clavien-Dindo grade 3-5), while diabetes and lymphoproliferative disorders were significantly associated with severe complications (Clavien-Dindo grade 4-5).CONCLUSION: This study demonstrates that overall complications to radical cystectomy are high (92%). The associations between specific comorbidities and complications need to be further investigated in order to evaluate whether pre-operative assessment can be more optimally used in a prevention strategy tailored to the individual patient.

KW - Bladder cancer

KW - co-morbidities

KW - complications

KW - cystectomy

KW - MORTALITY

KW - PERFORMANCE

KW - COMORBIDITY

KW - IMPACT

KW - PREDICTORS

KW - COHORT

KW - OUTCOMES

KW - ASSOCIATION

KW - INDEXES

KW - Multivariate Analysis

KW - Age Factors

KW - Humans

KW - Middle Aged

KW - Salvage Therapy

KW - Male

KW - Diabetes Mellitus, Type 2/epidemiology

KW - Lymphoproliferative Disorders/epidemiology

KW - Pulmonary Disease, Chronic Obstructive/epidemiology

KW - Postoperative Complications/epidemiology

KW - Aged, 80 and over

KW - Adult

KW - Female

KW - Renal Insufficiency, Chronic/epidemiology

KW - Retrospective Studies

KW - Urinary Bladder Neoplasms/epidemiology

KW - Carcinoma, Transitional Cell/epidemiology

KW - Severity of Illness Index

KW - Myocardial Infarction/epidemiology

KW - Comorbidity

KW - Cardiovascular Diseases/epidemiology

KW - Obesity/epidemiology

KW - Hypertension/epidemiology

KW - Urinary Diversion/statistics & numerical data

KW - Cystectomy/methods

KW - Aged

U2 - 10.1080/21681805.2018.1531921

DO - 10.1080/21681805.2018.1531921

M3 - Journal article

C2 - 30624138

SN - 2168-1805

VL - 52

SP - 395

EP - 400

JO - Scandinavian Journal of Urology

JF - Scandinavian Journal of Urology

IS - 5-6

ER -