Complications after prone PCNL in pediatric, adult and geriatric patients - a single center experience over 7 years
CROES-Clavien system (CCS) for grading complications in percutaneous nephrolithotomy (PCNL) is a step towards standardization of outcomes. We categorized complications based on CCS and predicted risk factors across the entire cohort and individually for pediatric (P: ≤18 years), adult (A: 19-65 year...
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| Veröffentlicht in: | International Brazilian Journal of Urology 2017-07, Vol.43 (4), p.704-712 |
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| creator | Kumar, Sumit Keshavamurthy, Ramaiah Karthikeyan, Vilvapathy Senguttuvan Mallya, Ashwin |
| description | CROES-Clavien system (CCS) for grading complications in percutaneous nephrolithotomy (PCNL) is a step towards standardization of outcomes. We categorized complications based on CCS and predicted risk factors across the entire cohort and individually for pediatric (P: ≤18 years), adult (A: 19-65 years) and geriatric (G: ≥65 years) subgroups to assess the risk factors in each subset. We assessed association of complications with length of hospitalization (LOH) and operation time (OT).
Retrospective record review of unilateral PCNL performed between January 2009-September 2015 at a tertiary care center in India, performing around 150 PCNL per year.
Out of 922 (P=61; A=794; G=67) PCNL, 259 (28.09%) complications occurred with CCS I, II, III and IV constituting 152 (16.49%), 72 (7.81%), 31 (3.36%) and 4 (0.43%) respectively and its distribution was similar across the subsets and majority (224; 24.3%) were minor (CCS-1, 2). Placement of a nephrostomy (47.4%; 18/38) in Group P, supracostal access, ≥2 punctures, higher GSS, nephrostomy, staghorn stones, ≥2 stones, stone size in Group A and hydronephrosis and prolonged OT in Group G were significantly associated with complications. On logistic regression, need of nephrostomy (adj. OR - 4.549), OT (adj. OR - 1.364) and supracostal access (adj. OR - 1.471) significantly contributed to complications in the study population. LOH was found to be significantly associated with complications (p |
| doi_str_mv | 10.1590/S1677-5538.IBJU.2016.0563 |
| format | Article |
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Retrospective record review of unilateral PCNL performed between January 2009-September 2015 at a tertiary care center in India, performing around 150 PCNL per year.
Out of 922 (P=61; A=794; G=67) PCNL, 259 (28.09%) complications occurred with CCS I, II, III and IV constituting 152 (16.49%), 72 (7.81%), 31 (3.36%) and 4 (0.43%) respectively and its distribution was similar across the subsets and majority (224; 24.3%) were minor (CCS-1, 2). Placement of a nephrostomy (47.4%; 18/38) in Group P, supracostal access, ≥2 punctures, higher GSS, nephrostomy, staghorn stones, ≥2 stones, stone size in Group A and hydronephrosis and prolonged OT in Group G were significantly associated with complications. On logistic regression, need of nephrostomy (adj. OR - 4.549), OT (adj. OR - 1.364) and supracostal access (adj. OR - 1.471) significantly contributed to complications in the study population. LOH was found to be significantly associated with complications (p<0.001).
Contrary to the belief that extremes of ages are associated with complications of prone PCNL, we found age does not alter the incidence or grade of complications and LOH.</description><identifier>ISSN: 1677-5538</identifier><identifier>ISSN: 1677-6119</identifier><identifier>EISSN: 1677-6119</identifier><identifier>EISSN: 1677-5538</identifier><identifier>DOI: 10.1590/S1677-5538.IBJU.2016.0563</identifier><identifier>PMID: 28783266</identifier><language>eng</language><publisher>Brazil: Sociedade Brasileira de Urologia</publisher><subject>Adolescent ; Adult ; Age Factors ; Aged ; Child ; complications [Subheading] ; Female ; Humans ; Kidney Calculi ; Kidney Calculi - surgery ; Length of Stay ; Male ; Middle Aged ; Nephrostomy, Percutaneous ; Nephrostomy, Percutaneous - adverse effects ; Nephrostomy, Percutaneous - statistics & numerical data ; Operative Time ; Original ; Patient Positioning ; Postoperative Complications ; Prone Position ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Treatment Outcome</subject><ispartof>International Brazilian Journal of Urology, 2017-07, Vol.43 (4), p.704-712</ispartof><rights>Copyright® by the International Brazilian Journal of Urology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c584t-f0fc9929ee0218dcf867d507372c6183013045dff2b4281cc122592933ce61c53</citedby><cites>FETCH-LOGICAL-c584t-f0fc9929ee0218dcf867d507372c6183013045dff2b4281cc122592933ce61c53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5557447/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5557447/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28783266$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kumar, Sumit</creatorcontrib><creatorcontrib>Keshavamurthy, Ramaiah</creatorcontrib><creatorcontrib>Karthikeyan, Vilvapathy Senguttuvan</creatorcontrib><creatorcontrib>Mallya, Ashwin</creatorcontrib><title>Complications after prone PCNL in pediatric, adult and geriatric patients - a single center experience over 7 years</title><title>International Brazilian Journal of Urology</title><addtitle>Int Braz J Urol</addtitle><description>CROES-Clavien system (CCS) for grading complications in percutaneous nephrolithotomy (PCNL) is a step towards standardization of outcomes. We categorized complications based on CCS and predicted risk factors across the entire cohort and individually for pediatric (P: ≤18 years), adult (A: 19-65 years) and geriatric (G: ≥65 years) subgroups to assess the risk factors in each subset. We assessed association of complications with length of hospitalization (LOH) and operation time (OT).
Retrospective record review of unilateral PCNL performed between January 2009-September 2015 at a tertiary care center in India, performing around 150 PCNL per year.
Out of 922 (P=61; A=794; G=67) PCNL, 259 (28.09%) complications occurred with CCS I, II, III and IV constituting 152 (16.49%), 72 (7.81%), 31 (3.36%) and 4 (0.43%) respectively and its distribution was similar across the subsets and majority (224; 24.3%) were minor (CCS-1, 2). Placement of a nephrostomy (47.4%; 18/38) in Group P, supracostal access, ≥2 punctures, higher GSS, nephrostomy, staghorn stones, ≥2 stones, stone size in Group A and hydronephrosis and prolonged OT in Group G were significantly associated with complications. On logistic regression, need of nephrostomy (adj. OR - 4.549), OT (adj. OR - 1.364) and supracostal access (adj. OR - 1.471) significantly contributed to complications in the study population. LOH was found to be significantly associated with complications (p<0.001).
Contrary to the belief that extremes of ages are associated with complications of prone PCNL, we found age does not alter the incidence or grade of complications and LOH.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Child</subject><subject>complications [Subheading]</subject><subject>Female</subject><subject>Humans</subject><subject>Kidney Calculi</subject><subject>Kidney Calculi - surgery</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nephrostomy, Percutaneous</subject><subject>Nephrostomy, Percutaneous - adverse effects</subject><subject>Nephrostomy, Percutaneous - statistics & numerical data</subject><subject>Operative Time</subject><subject>Original</subject><subject>Patient Positioning</subject><subject>Postoperative Complications</subject><subject>Prone Position</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Treatment Outcome</subject><issn>1677-5538</issn><issn>1677-6119</issn><issn>1677-6119</issn><issn>1677-5538</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>DOA</sourceid><recordid>eNpVkUtv1DAUhS0EoqXwF5DZk8GP-LVBghHQQSNAgq4tx74ePMokkZ2p2n-P02krurJ97jnflXUQekfJigpDPvymUqlGCK5Xm8_fr1aMULkiQvJn6PxuJCk1z-_vi-0MvSplTwgzRNGX6IxppTmT8hyV9XiY-uTdnMahYBdnyHjK4wD41_rHFqcBTxCSm3Py77ELx37Gbgh4B_kk4qlGYZgLbrDDJQ27HrCvQuXAzVRtMHjA43V9K3wLLpfX6EV0fYE39-cFuvr65c_6stn-_LZZf9o2Xuh2biKJ3hhmAAijOviopQqCKK6Yl1RzQjlpRYiRdS3T1HvKmKh-zj1I6gW_QJsTN4xub6ecDi7f2tEleyeMeWddnpPvwRoVHURDuwDQciI7o6R0wJ2WRHATKuvjiTUduwOE5YPZ9U-gTydD-mt347UVQqi2VRVgTgCfx1IyxMcsJXZp1ZalLrvUZVO3P9qlVbu0WrNv_1_-mHyokf8Di0Ogpg</recordid><startdate>20170701</startdate><enddate>20170701</enddate><creator>Kumar, Sumit</creator><creator>Keshavamurthy, Ramaiah</creator><creator>Karthikeyan, Vilvapathy Senguttuvan</creator><creator>Mallya, Ashwin</creator><general>Sociedade Brasileira de Urologia</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20170701</creationdate><title>Complications after prone PCNL in pediatric, adult and geriatric patients - a single center experience over 7 years</title><author>Kumar, Sumit ; Keshavamurthy, Ramaiah ; Karthikeyan, Vilvapathy Senguttuvan ; Mallya, Ashwin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c584t-f0fc9929ee0218dcf867d507372c6183013045dff2b4281cc122592933ce61c53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Child</topic><topic>complications [Subheading]</topic><topic>Female</topic><topic>Humans</topic><topic>Kidney Calculi</topic><topic>Kidney Calculi - surgery</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nephrostomy, Percutaneous</topic><topic>Nephrostomy, Percutaneous - adverse effects</topic><topic>Nephrostomy, Percutaneous - statistics & numerical data</topic><topic>Operative Time</topic><topic>Original</topic><topic>Patient Positioning</topic><topic>Postoperative Complications</topic><topic>Prone Position</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kumar, Sumit</creatorcontrib><creatorcontrib>Keshavamurthy, Ramaiah</creatorcontrib><creatorcontrib>Karthikeyan, Vilvapathy Senguttuvan</creatorcontrib><creatorcontrib>Mallya, Ashwin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>International Brazilian Journal of Urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kumar, Sumit</au><au>Keshavamurthy, Ramaiah</au><au>Karthikeyan, Vilvapathy Senguttuvan</au><au>Mallya, Ashwin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Complications after prone PCNL in pediatric, adult and geriatric patients - a single center experience over 7 years</atitle><jtitle>International Brazilian Journal of Urology</jtitle><addtitle>Int Braz J Urol</addtitle><date>2017-07-01</date><risdate>2017</risdate><volume>43</volume><issue>4</issue><spage>704</spage><epage>712</epage><pages>704-712</pages><issn>1677-5538</issn><issn>1677-6119</issn><eissn>1677-6119</eissn><eissn>1677-5538</eissn><abstract>CROES-Clavien system (CCS) for grading complications in percutaneous nephrolithotomy (PCNL) is a step towards standardization of outcomes. We categorized complications based on CCS and predicted risk factors across the entire cohort and individually for pediatric (P: ≤18 years), adult (A: 19-65 years) and geriatric (G: ≥65 years) subgroups to assess the risk factors in each subset. We assessed association of complications with length of hospitalization (LOH) and operation time (OT).
Retrospective record review of unilateral PCNL performed between January 2009-September 2015 at a tertiary care center in India, performing around 150 PCNL per year.
Out of 922 (P=61; A=794; G=67) PCNL, 259 (28.09%) complications occurred with CCS I, II, III and IV constituting 152 (16.49%), 72 (7.81%), 31 (3.36%) and 4 (0.43%) respectively and its distribution was similar across the subsets and majority (224; 24.3%) were minor (CCS-1, 2). Placement of a nephrostomy (47.4%; 18/38) in Group P, supracostal access, ≥2 punctures, higher GSS, nephrostomy, staghorn stones, ≥2 stones, stone size in Group A and hydronephrosis and prolonged OT in Group G were significantly associated with complications. On logistic regression, need of nephrostomy (adj. OR - 4.549), OT (adj. OR - 1.364) and supracostal access (adj. OR - 1.471) significantly contributed to complications in the study population. LOH was found to be significantly associated with complications (p<0.001).
Contrary to the belief that extremes of ages are associated with complications of prone PCNL, we found age does not alter the incidence or grade of complications and LOH.</abstract><cop>Brazil</cop><pub>Sociedade Brasileira de Urologia</pub><pmid>28783266</pmid><doi>10.1590/S1677-5538.IBJU.2016.0563</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Age Factors Aged Child complications [Subheading] Female Humans Kidney Calculi Kidney Calculi - surgery Length of Stay Male Middle Aged Nephrostomy, Percutaneous Nephrostomy, Percutaneous - adverse effects Nephrostomy, Percutaneous - statistics & numerical data Operative Time Original Patient Positioning Postoperative Complications Prone Position Retrospective Studies Risk Factors Severity of Illness Index Treatment Outcome |
| title | Complications after prone PCNL in pediatric, adult and geriatric patients - a single center experience over 7 years |
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