Measuring the Impact of Postsimultaneous Pancreas–Kidney Transplantation Complications: Comparing the Comprehensive Complication Index and Clavien–Dindo Classification

IF 1.9 4区医学 Q2 SURGERY Clinical Transplantation Pub Date : 2024-08-30 DOI:10.1111/ctr.15440

Yeqi Nian, Lu Hu, Yu Cao, Zhen Wang, Hui Wang, Gang Feng, Jie Zhao, Jianming Zheng, Wenli Song

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Abstract

Introduction

The Clavien–Dindo classification (CDC) is commonly used for assessing postoperative complications; however, it may not be comprehensive. A comprehensive complication index (CCI) was introduced to address this limitation. This study aimed to compare the effectiveness of the CCI and CDC in evaluating the complications after simultaneous pancreas–kidney (SPK) transplantation.

Methods

Data were collected from patients who underwent SPK transplantation at our center between February 2018 and February 2021. Complications encountered during hospitalization were assessed using both the CDC and CCI. Linear regression analyses were performed to identify the factors related to postoperative length of stay (PLOS).

Results

Overall, 125 patients were included, with an average age of 46.87 years. Type 2 diabetes was present in 79% of the recipients. Among them, 117 patients experienced postoperative complications of CDC grades I (2.4%), II (57.6%), IIIa (8.0%), IIIb (9.6%), IVa (14.4%), IVb (0.8%), and V (0.8%) postoperative complications. The median CCI for the entire cohort was 37.2. Spearman's correlation analysis revealed significant associations between the CDC and PLOS and the CCI and PLOS. Notably, CCI exhibited a stronger correlation with PLOS (CCI: ρ = 0.698 vs. CDC: ρ = 0.524; p = 0.024).

Conclusion

The CCI demonstrated a stronger correlation with PLOS than CDC. Our finding suggests that the CCI may be a useful tool for comprehensively assessing complications following SPK transplantation.

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衡量同期胰肾移植术后并发症的影响：比较综合并发症指数和克拉维恩-丁多分类法

导言：Clavien-Dindo 分类法（CDC）常用于评估术后并发症，但可能并不全面。综合并发症指数（CCI）的引入正是为了解决这一局限性。本研究旨在比较 CCI 和 CDC 在评估同步胰肾（SPK）移植术后并发症方面的有效性。方法收集2018年2月至2021年2月期间在本中心接受SPK移植的患者数据。使用 CDC 和 CCI 评估住院期间遇到的并发症。进行线性回归分析以确定与术后住院时间（PLOS）相关的因素。结果共纳入 125 名患者，平均年龄为 46.87 岁。79%的受术者患有 2 型糖尿病。其中，117 名患者出现了 CDC I 级（2.4%）、II 级（57.6%）、IIIa 级（8.0%）、IIIb 级（9.6%）、IVa 级（14.4%）、IVb 级（0.8%）和 V 级（0.8%）术后并发症。整个组群的 CCI 中位数为 37.2。斯皮尔曼相关性分析表明，CDC 和 PLOS 以及 CCI 和 PLOS 之间存在显著相关性。值得注意的是，CCI 与 PLOS 的相关性更强（CCI：ρ = 0.698 vs. CDC：ρ = 0.524; p = 0.024）。结论 CCI 与 PLOS 的相关性强于 CDC。我们的发现表明，CCI 可能是全面评估 SPK 移植后并发症的有用工具。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.