Postoperative complications and 90-day mortality in radical cystectomy in high-risk patients: A monocentric retrospective observational study

Aim: Assessing the incidence of immediate postoperative complications and 90-day mortality in high-risk patients who have undergone radical cystectomy; evaluating the correlation between preoperative conditions and surgery outcomes. Materials and methods: This is a monocentric retrospective observational study in which data of 65 patients have been analyzed. High-risk criteria: (a) Age 6575 years, (b) obesity, (c) age-adjusted Charlson Comorbidity Index 658, (d) anemic status, and (e) pT 653. More than 50% of patients had two or more \u201chigh-risk\u201d indicators. Postoperative complications were assessed through Clavien\u2013Dindo classification. Results: Average age of patients was 70.4 years, average age-adjusted Charlson Comorbidity Index was 5.8, and average body mass index was 27.5. In 28% of patients, no complications arose, while in 46% grades I\u2013II according to Clavien\u2013Dindo occurred, in 23% grades III\u2013IV occurred, and in 3% of the patients, death arose in the immediate postoperative period (grade V). Overall, 90-day mortality rate after surgery was 12.3%. The age 6575years and an age-adjusted Charlson Comorbidity Index score 658 have shown to be risk factors for the onset of severe complications (odds ratio = 3.54, p = 0.028 and odds ratio = 4.7, p = 0.026), while preoperative anemic status was for complications in general (odds ratio = 4.1, p = 0.015). No analyzed parameter was a predictor of 90-day mortality (p > 0.05). Conclusion: Immediate postoperative complications and 90-day mortality in radical cystectomy in high-risk patients remain significant, but still in line with the data in the literature on comparable populations. Some of the preoperative parameters were able to predict the outcomes of the intervention with regard to the onset of complications but not to the 90-day mortality