Performance of Comprehensive Complication Index and Clavien-Dindo Complication Scoring System in Liver Surgery for Hepatocellular Carcinoma

Alessandro Giani, Federica Cipriani, Simone Famularo, Matteo Donadon, Davide P Bernasconi, Francesco Ardito, Federico Fazio, Daniele Nicolini, Pasquale Perri, Mario Giuffrida, Nicholas Pontarolo, Matteo Zanello, Quirino Lai, Simone Conci, Sarah Molfino, Paola Germani, Enrico Pinotti, Maurizio Romano, Giuliano La Barba, Cecilia FerrariStefan Patauner, Alberto Manzoni, Ivano Sciannamea, Luca Fumagalli, Albert Troci, Valentina Ferraro, Antonio Floridi, Riccardo Memeo, Michele Crespi, Marco Chiarelli, Adelmo Antonucci, Giuseppe Zimmitti, Antonio Frena, Andrea Percivale, Giorgio Ercolani, Giacomo Zanus, Mauro Zago, Paola Tarchi, Gian Luca Baiocchi, Andrea Ruzzenente, Massimo Rossi, Elio Jovine, Marcello Maestri, Raffaele Dalla Valle, GianLuca Grazi, Marco Vivarelli, Alessandro Ferrero, Felice Giuliante, Guido Torzilli, Luca Aldrighetti, Luca Gianotti, Fabrizio Romano, Cristina Ciulli, Marco Braga, Francesca Ratti, Guido Costa, Francesco Razionale, Nadia Russolillo, Laura Marinelli, Valerio De Peppo, Elena Cremaschi, Francesco Calabrese, Zoe Larghi Laureiro, Giovanni Lazzari, Davide Cosola, Mauro Montuori, Luca Salvador, Alessandro Cucchetti, Angelo Franceschi, Michele Ciola, Valentina Sega, Pietro Calcagno, Luca Pennacchi, Michele Tedeschi

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: We aimed to assess the ability of comprehensive complication index (CCI) and Clavien-Dindo complication (CDC) scale to predict excessive length of hospital stay (e-LOS) in patients undergoing liver resection for hepatocellular carcinoma.

METHODS: Patients were identified from an Italian multi-institutional database and randomly selected to be included in either a derivation or validation set. Multivariate logistic regression models and ROC curve analysis including either CCI or CDC as predictors of e-LOS were fitted to compare predictive performance. E-LOS was defined as a LOS longer than the 75th percentile among patients with at least one complication.

RESULTS: A total of 2669 patients were analyzed (1345 for derivation and 1324 for validation). The odds ratio (OR) was 5.590 (95%CI 4.201; 7.438) for CCI and 5.507 (4.152; 7.304) for CDC. The AUC was 0.964 for CCI and 0.893 for CDC in the derivation set and 0.962 vs. 0.890 in the validation set, respectively. In patients with at least two complications, the OR was 2.793 (1.896; 4.115) for CCI and 2.439 (1.666; 3.570) for CDC with an AUC of 0.850 and 0.673, respectively in the derivation cohort. The AUC was 0.806 for CCI and 0.658 for CDC in the validation set.

CONCLUSIONS: When reporting postoperative morbidity in liver surgery, CCI is a preferable scale.

Original languageEnglish
JournalCancers
Volume12
Issue number12
DOIs
Publication statusPublished - Dec 21 2020

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