Charlson Comorbidity Index can be a Predictor of Post-Operative Complications and Hospital Stay by Using Clavien-Dindo Classification of Patients Undergoing Per-Cutaneous Nephrolithotomy

Abstract

Abstract: Background: The post-operative complications after PCNL are comparatively higher in patients with comorbidities such as old age, recurrent renal stones, multiple stones, stone location and composition.

Objective: The purpose of this study is to evaluate the efficacy of Charlson comorbidity index to predict the post-operative complications and hospital stay of elderly patients by using Clavien Dindo classification under-going PCNL.

Materials and Methods: This is a prospective follow-up study, conducted at urology department of Tabba Kidney Institute. Patient aged ? 50 years, both genders diagnosed with Single or multiple, unilateral or bilateral renal stones and, solitary kidney were included in the study. CCI  and Clavien Dindo classifications were documented and analyzed for associated and independent results. SPSS 22 was used to analyze the data.

Result: Total 152 participants were recruited in the study. The mean age of study population was 53.5 ± 14.2 years, with range of 38 years. Stone clearance was reported as 97% with 147(96.7%) complete stone free cases and 5(3.2%) cases with confirmed residual stones requiring METs to achieve complete clearance. Correlation of CCI and Clavien Dindo classification identified that there is a direct association with higher grading of both classification with post-operative complications. Assessment of odds of outcome were higher in Grade III Clavien Dindo with 1.48 indicating positive odds of complications and CCI higher grading.

Conclusion: Charlson Comorbidity Index is a swift, simple, and reproducible scoring system to properly calculate the morbidity and mortality after PCNL.