You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging II1 Apr 2017MP67-18 THE COMPREHENSIVE COMPLICATION INDEX (CCI) IS SUPERIOR TO THE CLAVIEN-DINDO GRADING SYSTEM IN PREDICTING LENGTH OF STAY AND HOSPITAL READMISSION FOLLOWING RADICAL NEPHROURETERECTOMY Scott Geiger, Neil Kocher, Dan Ilinsky, Evanguelos Xylinas, Peter Chang, Lauren Dewey, Andrew A. Wagner, Firas Petros, Surena F. Matin, Conrad Tobert, Chad Tracy, Patard Pierre-Marie, Mathieu Roumiguie, Leonardo Lima Monteiro, Wassim Kassouf, and Jay D. Raman Scott GeigerScott Geiger More articles by this author , Neil KocherNeil Kocher More articles by this author , Dan IlinskyDan Ilinsky More articles by this author , Evanguelos XylinasEvanguelos Xylinas More articles by this author , Peter ChangPeter Chang More articles by this author , Lauren DeweyLauren Dewey More articles by this author , Andrew A. WagnerAndrew A. Wagner More articles by this author , Firas PetrosFiras Petros More articles by this author , Surena F. MatinSurena F. Matin More articles by this author , Conrad TobertConrad Tobert More articles by this author , Chad TracyChad Tracy More articles by this author , Patard Pierre-MariePatard Pierre-Marie More articles by this author , Mathieu RoumiguieMathieu Roumiguie More articles by this author , Leonardo Lima MonteiroLeonardo Lima Monteiro More articles by this author , Wassim KassoufWassim Kassouf More articles by this author , and Jay D. RamanJay D. Raman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2054AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Complication rates following radical nephroureterectomy (RNU) are reported to occur in 20-30% of patients. The Clavien-Dindo (CD) grading system is a well-known categorical classification of complication severity. The Comprehensive Complications Index (CCI) is an alternative grading system that aggregrates all complications experienced by a patient expressed on a continuous 0-100 scale. We investigate whether the cumulative nature of CCI renders it superior to CD in predicting perioperative course after RNU. METHODS The records of 532 consecutive patents who underwent RNU at 7 academic medical centers between 2005-2015 were reviewed. Complications occurring within 30 days of RNU were annotated with grading both by the CD and CCI classification systems. Logistic regression was used to determined associations between CD and CCI with perioperative covariates as well as with hospital length of stay (LOS) and readmission. RESULTS 377 men and 219 women with a median age of 71, BMI of 27, and Charlson comorbidy score of 4 were included. 60% had an ASA score > 2, 22% were ECOG > 2, and 59% had baseline CKD stage III or greater. Approximately 75% underwent a minimally invasive RNU. Median LOS following RNU was 6.0 days (range, 1-37) and readmission within 30 days occurred in 45 (7%) 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 Charlson score, ECOG > 2, and CKD stage > III (p for all < 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, p =0.02) after RNU whilst major CD complications were not (LOS 7.4 vs. 5.6 days, p=0.14; Readmission OR 1.4, p=0.21). CONCLUSIONS The CD and CCI classification systems both have their utility in evaluating baseline and perioperative characteristics for RNU patients. However, the continuous and cumulative nature of the CCI that accounts for complications severity appears to allow for superior prediction of perioperative course including LOS and readmission. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e878 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Scott Geiger More articles by this author Neil Kocher More articles by this author Dan Ilinsky More articles by this author Evanguelos Xylinas More articles by this author Peter Chang More articles by this author Lauren Dewey More articles by this author Andrew A. Wagner More articles by this author Firas Petros More articles by this author Surena F. Matin More articles by this author Conrad Tobert More articles by this author Chad Tracy More articles by this author Patard Pierre-Marie More articles by this author Mathieu Roumiguie More articles by this author Leonardo Lima Monteiro More articles by this author Wassim Kassouf More articles by this author Jay D. Raman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...