The Comprehensive Complication Index (CCI) demonstrated superior predictive performance for excessive length of hospital stay compared to the Clavien-Dindo scale (AUC 0.964 vs 0.893).
Observational (n=2,669)
Yes
Does the comprehensive complication index (CCI) predict excessive length of hospital stay better than the Clavien-Dindo complication (CDC) scale in patients undergoing liver resection for hepatocellular carcinoma?
The comprehensive complication index (CCI) is superior to the Clavien-Dindo complication scale for predicting excessive length of hospital stay in patients undergoing liver resection for hepatocellular carcinoma.
Effect estimate: OR 5.590 (95% CI 4.201-7.438)
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.
Giani et al. (Mon,) conducted a observational in Hepatocellular carcinoma undergoing liver resection (n=2,669). Comprehensive complication index (CCI) vs. Clavien-Dindo complication (CDC) scale was evaluated on Excessive length of hospital stay (e-LOS) (OR 5.590, 95% CI 4.201-7.438). The Comprehensive Complication Index (CCI) demonstrated superior predictive performance for excessive length of hospital stay compared to the Clavien-Dindo scale (AUC 0.964 vs 0.893).