Tamini Nicolò, Bernasconi Davide, Ripamonti Lorenzo, Lo Bianco Giulia, Braga Marco, Nespoli Luca
School of Medicine and Surgery, University Milano-Bicocca, 20900 Monza, Italy.
ASST Ospedale San Gerardo, 20090 Monza, Italy.
Cancers (Basel). 2021 Apr 6;13(7):1745. doi: 10.3390/cancers13071745.
(1) Introduction: To date, the sensitivity of the Comprehensive Complication Index (CCI) in a homogeneous cohort of colonic resections for oncologic purposes has not been reported. The present study aims to compare the CCI with the conventional Clavien-Dindo classification (CDC) in colon cancer patients. (2) Methods: The clinical data of patients submitted to an elective colectomy for adenocarcinoma were retrieved from a prospectively maintained database. Postoperative complications and length of stay were reviewed, and CDC and CCI scores were calculated for each patient. The association of the CCI and the CDC with the length of stay, prolongation of stay and readmission rate were assessed and compared. (3) Results: The overall postoperative morbidity was 26.9%. In particular, 157 (20.4%) patients had more than one complication. A strong correlation between the two scoring systems was observed (r = 99.4%; 95%CI: 99.3-99.5%). In multivariate analysis, CCI had a higher predictive ability for all endpoints. Regarding subgroup analysis, the difference between the CCI and CDC was progressively increased when evaluating outcome measures in complicated and multi-complicated patients. (4) Conclusion: Both scoring systems adequately report the overall burden of postoperative complications. The CCI showed a greater ability than the CDC to predict hospital stay, particularly in patients with multiple postoperative complications.
(1) 引言：迄今为止，尚未报道综合并发症指数（CCI）在用于肿瘤目的的结肠切除术同质队列中的敏感性。本研究旨在比较结肠癌患者中CCI与传统的Clavien-Dindo分类（CDC）。(2) 方法：从一个前瞻性维护的数据库中检索接受择期腺癌结肠切除术患者的临床资料。回顾术后并发症和住院时间，并计算每位患者的CDC和CCI评分。评估并比较CCI和CDC与住院时间、住院时间延长和再入院率的相关性。(3) 结果：总体术后发病率为26.9%。特别是，157例（20.4%）患者有不止一种并发症。观察到两种评分系统之间有很强的相关性（r = 99.4%；95%CI：99.3 - 99.5%）。在多变量分析中，CCI对所有终点具有更高的预测能力。关于亚组分析，在评估复杂和多复杂患者的结局指标时，CCI和CDC之间的差异逐渐增加。(4) 结论：两种评分系统都能充分反映术后并发症的总体负担。CCI在预测住院时间方面比CDC表现出更强的能力，特别是在有多种术后并发症的患者中。
