Predicting 90-day and long-term mortality in octogenarians undergoing radical cystectomy.
BMC Urol
; 18(1): 91, 2018 Oct 22.
Article
em En
| MEDLINE
| ID: mdl-30348141
ABSTRACT
BACKGROUND:
Radical cystectomy bears a considerable perioperative mortality risk particularly in elderly patients. In this study, we searched for predictors of perioperative and long-term competing (non-bladder cancer) mortality in elderly patients selected for radical cystectomy.METHODS:
We stratified 1184 consecutive patients who underwent radical cystectomy for high risk superficial or muscle-invasive urothelial or undifferentiated carcinoma of bladder into two groups (age < 80 years versus 80 years or older). Multivariable and cox proportional hazards models were used for data analysis.RESULTS:
Whereas Charlson score and the American Society of Anesthesiologists (ASA) physical status classification (but not age) were independent predictors of 90-day mortality in younger patients, only age predicted 90-day mortality in patients aged 80 years or older (odds ratio per year 1.24, p = 0.0422). Unlike in their younger counterparts, neither age nor Charlson score or ASA classification were predictors of long-term competing mortality in patients aged 80 years or older (hazard ratios 1.07-1.10, p values 0.21-0.77).CONCLUSIONS:
This data suggest that extrapolations of perioperative mortality or long-term mortality risks of younger patients to octogenarians selected for radical cystectomy should be used with caution. Concerning 90-day mortality, chronological age provided prognostic information whereas comorbidity did not.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Bexiga Urinária
/
Neoplasias da Bexiga Urinária
/
Cistectomia
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged80
/
Humans
Idioma:
En
Revista:
BMC Urol
Assunto da revista:
UROLOGIA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Alemanha