World journal of transplantation · 2025
Comparison of Clavien-Dindo classification and comprehensive complication index in patients undergoing simultaneous pancreas-kidney transplantation.
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Parente Alessandro, Verhoeff Kevin, Marfil-Garza Braulio A, Sanchez-Fernandez Norberto, Anderson Blaire L, Bigam David L, Shapiro Am James, Dajani Khaled Z
Аннотация
BACKGROUND: Detailed data on the relation of post-operative complications with clinical outcomes after simultaneous pancreas-kidney (SPK) transplantation is lacking.
AIM: To compare Clavien-Dindo classification (CDC) and comprehensive complication index (CCI) in predicting outcomes after SPK.
METHODS: Data for patients undergoing SPK between 1999-2019 were analyzed. Information on recipients' baseline characteristics, peri-operative management and post-operative complications were collated. Length of hospital stay (LOS) was the primary study outcome, and the associations with CDC and CCI were evaluated using Spearman's (ρ) correlation coefficients.
RESULTS: In the study period, data were available for 128 patients (female n = 44, 34.4%). Sixty-nine patients had at least one complication with the highest CDC grade of I, II, III, and IV in 8 (6.3%), 22 (17.2%), 32 (25%), and 7 (5.5%) patients, respectively. The mean LOS was 21.4 ± 17.7 days. Both classification systems were correlated with LOS, yet CCI was stronger (Spearman's ρ: 0.694 vs 0.602, P < 0.001). Female patients (P = 0.019) and patients with pre-transplant cardiovascular events (P = 0.02) had longer LOS. After adjusted multivariable analysis, the link between LOS and both the CDC and CCI remained relevant. CCI had a superior fit compared to CDC (r 2 = 0.729 vs r 2 = 0.481), with every 10 CCI points being associated with a 5.27 day (P < 0.001) increased LOS.
CONCLUSION: This study showed that the CCI was better linked with LOS compared to CDC and might represent a useful score to evaluate the overall burden of postoperative complications in patients undergoing SPK.
AIM: To compare Clavien-Dindo classification (CDC) and comprehensive complication index (CCI) in predicting outcomes after SPK.
METHODS: Data for patients undergoing SPK between 1999-2019 were analyzed. Information on recipients' baseline characteristics, peri-operative management and post-operative complications were collated. Length of hospital stay (LOS) was the primary study outcome, and the associations with CDC and CCI were evaluated using Spearman's (ρ) correlation coefficients.
RESULTS: In the study period, data were available for 128 patients (female n = 44, 34.4%). Sixty-nine patients had at least one complication with the highest CDC grade of I, II, III, and IV in 8 (6.3%), 22 (17.2%), 32 (25%), and 7 (5.5%) patients, respectively. The mean LOS was 21.4 ± 17.7 days. Both classification systems were correlated with LOS, yet CCI was stronger (Spearman's ρ: 0.694 vs 0.602, P < 0.001). Female patients (P = 0.019) and patients with pre-transplant cardiovascular events (P = 0.02) had longer LOS. After adjusted multivariable analysis, the link between LOS and both the CDC and CCI remained relevant. CCI had a superior fit compared to CDC (r 2 = 0.729 vs r 2 = 0.481), with every 10 CCI points being associated with a 5.27 day (P < 0.001) increased LOS.
CONCLUSION: This study showed that the CCI was better linked with LOS compared to CDC and might represent a useful score to evaluate the overall burden of postoperative complications in patients undergoing SPK.