Dataset Information

Performance of Comprehensive Complication Index and Clavien-Dindo Complication Scoring System in Liver Surgery for Hepatocellular Carcinoma.

ABSTRACT:

Background

We aimed to assess the ability of comprehensive complication index (CCI) and Clavien-Dindo complication (CDC) scale to predict excessive length of hospital stay (e-LOS) in patients undergoing liver resection for hepatocellular carcinoma.

Methods

Patients were identified from an Italian multi-institutional database and randomly selected to be included in either a derivation or validation set. Multivariate logistic regression models and ROC curve analysis including either CCI or CDC as predictors of e-LOS were fitted to compare predictive performance. E-LOS was defined as a LOS longer than the 75th percentile among patients with at least one complication.

Results

A total of 2669 patients were analyzed (1345 for derivation and 1324 for validation). The odds ratio (OR) was 5.590 (95%CI 4.201; 7.438) for CCI and 5.507 (4.152; 7.304) for CDC. The AUC was 0.964 for CCI and 0.893 for CDC in the derivation set and 0.962 vs. 0.890 in the validation set, respectively. In patients with at least two complications, the OR was 2.793 (1.896; 4.115) for CCI and 2.439 (1.666; 3.570) for CDC with an AUC of 0.850 and 0.673, respectively in the derivation cohort. The AUC was 0.806 for CCI and 0.658 for CDC in the validation set.

Conclusions

When reporting postoperative morbidity in liver surgery, CCI is a preferable scale.

SUBMITTER: Giani A

PROVIDER: S-EPMC7767420 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Publications

Performance of Comprehensive Complication Index and Clavien-Dindo Complication Scoring System in Liver Surgery for Hepatocellular Carcinoma.

Giani Alessandro A Cipriani Federica F Famularo Simone S Donadon Matteo M Bernasconi Davide P DP Ardito Francesco F Fazio Federico F Nicolini Daniele D Perri Pasquale P Giuffrida Mario M Pontarolo Nicholas N Zanello Matteo M Lai Quirino Q Conci Simone S Molfino Sarah S Germani Paola P Pinotti Enrico E Romano Maurizio M La Barba Giuliano G Ferrari Cecilia C Patauner Stefan S Manzoni Alberto A Sciannamea Ivano I Fumagalli Luca L Troci Albert A Ferraro Valentina V Floridi Antonio A Memeo Riccardo R Crespi Michele M Chiarelli Marco M Antonucci Adelmo A Zimmitti Giuseppe G Frena Antonio A Percivale Andrea A Ercolani Giorgio G Zanus Giacomo G Zago Mauro M Tarchi Paola P Baiocchi Gian Luca GL Ruzzenente Andrea A Rossi Massimo M Jovine Elio E Maestri Marcello M Dalla Valle Raffaele R Grazi GianLuca G Vivarelli Marco M Ferrero Alessandro A Giuliante Felice F Torzilli Guido G Aldrighetti Luca L Gianotti Luca L Romano Fabrizio F Ciulli Cristina C Braga Marco M Ratti Francesca F Costa Guido G Razionale Francesco F Russolillo Nadia N Marinelli Laura L De Peppo Valerio V Cremaschi Elena E Calabrese Francesco F Larghi Laureiro Zoe Z Lazzari Giovanni G Cosola Davide D Montuori Mauro M Salvador Luca L Cucchetti Alessandro A Franceschi Angelo A Ciola Michele M Sega Valentina V Calcagno Pietro P Pennacchi Luca L Tedeschi Michele M

Cancers 20201221 12

<h4>Background</h4>We aimed to assess the ability of comprehensive complication index (CCI) and Clavien-Dindo complication (CDC) scale to predict excessive length of hospital stay (e-LOS) in patients undergoing liver resection for hepatocellular carcinoma.<h4>Methods</h4>Patients were identified from an Italian multi-institutional database and randomly selected to be included in either a derivation or validation set. Multivariate logistic regression models and ROC curve analysis including either ...[more]

PMID: 33371419

Similar Datasets

Project description:BackgroundComplications can occur following radical nephroureterectomy (RNU) in 20-40% of patients. The Comprehensive Complication Index (CCI) is an alternative grading system to the Clavien-Dindo (CD) grading system that aggregates all complications experienced by a patient on a continuous (as opposed to categorical) scale. We investigate whether the cumulative nature of CCI renders it superior to CD in predicting perioperative course after RNU.MethodsThe records of 596 patents who underwent RNU at 7 academic medical centers from 2005 to 2015 were reviewed. Complications occurring within 30 days of RNU were annotated using both the CD and CCI classification systems. Logistic regression was used to determine associations between CD and CCI with perioperative covariates as well as measures of convalescence [hospital length of stay (LOS) and readmission].ResultsA total of 377 men and 219 women with a median age of 71, BMI of 27, and Charlson comorbidity score of 4 were included. Over half underwent a minimally invasive RNU. Median LOS following RNU was 6.0 days (range, 1-37 days) and readmission within 30-days occurred in 45 (8%) patients. Overall, 136 patients (23%) experienced a post-operative complication with 91 having a single complication and 45 with multiple (range, 2-6); 44 (7%) patients had Clavien III or greater complications, and the median CCI for those patients experiencing a complication was 20.9 (range, 8.7-100). Both the upper quartile of CCI (≥75th %) and major CD complications were associated with higher baseline Charlson score, ECOG ≥2, and CKD stage ≥ III (all P<0.05). However, only the upper quartile of CCI was associated with LOS (8.9 vs. 5.4 days, P<0.01) and hospital readmission (OR 3.2, 95% CI: 1.9-5.6, P=0.02) after RNU.ConclusionsThe CD and CCI classification systems both are associated with similar baseline and perioperative characteristics for RNU patients. However, the cumulative nature of the CCI allows for superior prediction of postoperative course after RNU including LOS and readmission.

Dataset Information

Performance of Comprehensive Complication Index and Clavien-Dindo Complication Scoring System in Liver Surgery for Hepatocellular Carcinoma.

Background

Methods

Results

Conclusions

Publications

Performance of Comprehensive Complication Index and Clavien-Dindo Complication Scoring System in Liver Surgery for Hepatocellular Carcinoma.

Similar Datasets

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