The Comprehensive Complication Index CCI: A proposed modification to optimize short-term complication reporting after cystectomy and urinary diversion

Furrer, Marc A.; Huesler, Juerg; Fellmann, Adrian; Burkhard, Fiona C.; Thalmann, George N.; Wuethrich, Patrick Y.

doi:10.1016/j.urolonc.2018.12.013

Cited by 25 publications

(16 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found that most of the patients (83%) experienced at least one perioperative adverse incident. The obtained results correspond with other RC studies, in which the complication rate ranges from 82% to 99% [ 4 , 16 ]. The most common complications we observed include genitourinary, gastrointestinal and infectious ones, which is consistent with the findings of other studies [ 4 ].…”

Section: Discussionsupporting

confidence: 90%

“…Both this study and previous papers confirm that the CCI is a significant upgrade in reporting perioperative morbidity. Like other authors, we found a significant increase in the recorded incidence of morbidity assessed by the CCI in relation to the CDC [ 4 , 16 ]. In our study, the threshold for the most serious complications according to the CDC (from IIIb grade) was 14%, and in CCI, estimated from 33.7, was 12% 26%.…”

Section: Discussionsupporting

confidence: 87%

“…We suggest a more complementary assessment of perioperative complications using the CCI, which has the ability to capture cumulative morbidities. To our knowledge, the assessment of perioperative morbidity after RC by means of the CCI has not been frequently used by other authors [ 4 , 16 ]. Both this study and previous papers confirm that the CCI is a significant upgrade in reporting perioperative morbidity.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The Comprehensive Complication Index. Proposed modification to improve estimates of perioperative morbidity after radical cystectomy. A pilot study

Zaręba

Jaskulski

Orłowski

et al. 2021

Cent european J Urol

View full text Add to dashboard Cite

Introduction The aim of this article was to compare the 30-day morbidity after radical cystectomy comparing the prevalent Clavien-Dindo Classification (CDC) and the novel Comprehensive Complication Index (CCI). Additionally, we evaluated the correlation between particular clinical features and the severity of perioperative morbidity. Material and methods A total of 42 patients were included into the study (33 men and 9 women) who underwent open radical cystectomy (RC) with bilateral lymphadenectomy for bladder cancer. The selection of complications was based on groundbreaking research on morbidity after RC. The assessment of perioperative complications was performed using the CDC and then the CCI. Results The CCI was found to be a significant upgrade in capturing cumulative morbidity in comparison to the CDC when used as the only evaluational tool. Conclusions Using only the CDC may underestimate the severity of perioperative complications. Unfavorable clinical features e.g. older age, chronic kidney disease (CKD), persistent nodal (pN+) disease, prior abdominal and pelvic surgeries as well as smoking are of significant importance for the increase of the severity of perioperative complications.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Comprehensive Complication Index. Proposed modification to improve estimates of perioperative morbidity after radical cystectomy. A pilot study

Zaręba

Jaskulski

Orłowski

et al. 2021

Cent european J Urol

View full text Add to dashboard Cite

show abstract

“…They found comparable results (mean non-cumulative CCI: 21; mean cumulative CCI: 29) to our study (mean noncumulative CCI: 21 mean cumulative CCI: 27). Furrer et al proposed a modified Berne CCI specifically for RC since complicated postoperative courses can also result in a CCI of 99.4 for non-death cases [9]. The Berne CCI was able to predict death between postoperative day 90 to 1 year.…”

Section: Discussionmentioning

confidence: 99%

“…Despite its acceptance in general surgery, the CCI is not yet validated for urological procedures. Despite Vetterlein et al and Furrer et al applied the CCI to report on their respective patient cohorts undergoing radical cystectomy (RC) [9,10], the CCI has not been used or validated for other major uro-oncological procedures such as radical prostatectomy (RP) or partial nephrectomy (PN). Therefore, the aim of the presented study was to introduce and validate the CCI for the three most common uro-oncological procedures (RC, RP and PN) using a patient cohort from a tertiary university referral center, and to analyze the CCI data distribution for these procedures.…”

Section: Introductionmentioning

confidence: 99%

The comprehensive complication index (CCI): proposal of a new reporting standard for complications in major urological surgery

et al. 2020

View full text Add to dashboard Cite

Purpose The comprehensive complication index (CCI) is a new tool for reporting the cumulative burden of postoperative complications on a continuous scale. This study validates the CCI for urological surgery and its benefits over the Clavien-Dindo-Classification (Clavien). Material and methods Data from a prospectively maintained data base of all consecutive patients at a university care-center was analyzed. Complications after radical cystectomy (RC), radical prostatectomy (RP), and partial nephrectomy (PN) were classified using the CCI and Clavien system. Differences in complications between the CCI and the Clavien were assessed and correlation analyses performed. Sample size calculations for hypothetical clinical trials were compared between CCI and Clavien to evaluate whether the CCI would reduce the number of required patients in a clinical trial. Results 682 patients (172 RC, 297 RP, 213 PN) were analyzed. Overall, 9.4-46.6% of patients had > 1 complication cumulatively assessed with the CCI resulting in an upgrading in the Clavien classification for 2.4-32.4% of patients. Therefore, scores between the systems differed for RC: CCI (mean ± standard deviation) 26.

show abstract

Active involvement of nursing staff in reporting and grading complication‐intervention events—Protocol and results of the CAMUS Pilot Nurse Delphi Study

et al. 2022

Self Cite

View full text Add to dashboard Cite

Objectives: The aim of this study is to gain experienced nursing perspective on current and future complication reporting and grading in Urology, establish the CAMUS CCI and quality control the use of the Clavien-Dindo Classification (CDC) in nursing staff. Subjects and Methods:The 12-part REDCap-based Delphi survey was developed in conjunction with expert nurse, urologist and methodologist input. Certified local and international inpatient and outpatient nurses specialised in urology, perioperative nurses and urology-specific advanced practice nurses/nurse practitioners will be included. A minimum sample size of 250 participants is targeted. The survey assesses participant demographics, nursing experience and opinion on complication reporting and the proposed CAMUS reporting recommendations; grading of intervention events using the existing CDC and the proposed CAMUS Classification; and rating various clinical scenarios. Consensus will be defined as ≥75% agreement. If consensus is not reached, subsequent Delphi rounds will be performed under Steering Committee guidance.Results: Twenty participants completed the pilot survey. Median survey completion time was 58 min . The survey revealed that 85% of nursing participants believe nurses should be involved in future complication reporting and grading but currently have poor confidence and inadequate relevant background education.Overall, 100% of participants recognise the universal demand for reporting consensus and 75% hold a preference towards the CAMUS System. Limitations include variability in nursing experience, complexity of supplemental grades and survey duration.

show abstract

The Comprehensive Complication Index CCI: A proposed modification to optimize short-term complication reporting after cystectomy and urinary diversion

Cited by 25 publications

References 29 publications

The Comprehensive Complication Index. Proposed modification to improve estimates of perioperative morbidity after radical cystectomy. A pilot study

The Comprehensive Complication Index. Proposed modification to improve estimates of perioperative morbidity after radical cystectomy. A pilot study

The comprehensive complication index (CCI): proposal of a new reporting standard for complications in major urological surgery

Active involvement of nursing staff in reporting and grading complication‐intervention events—Protocol and results of the CAMUS Pilot Nurse Delphi Study

Contact Info

Product

Resources

About