PD16-10 IS PCNL A SAFE AND EFFECTIVE OPTION FOR OCTOGENARIAN PATIENT?. ANALYSIS OF OVER 4000 CASES FROM A NATIONAL DATABASE.

You have accessJournal of UrologyStone Disease: Surgical Therapy I1 Apr 2017PD16-10 IS PCNL A SAFE AND EFFECTIVE OPTION FOR OCTOGENARIAN PATIENT?. ANALYSIS OF OVER 4000 CASES FROM A NATIONAL DATABASE. Stuart Irving, Oliver Wiseman, William Finch, James Armitage, Sarah Fowler, John Withington, Jonathan Glass, and Neil Burgess Stuart IrvingStuart Irving More articles by this author , Oliver WisemanOliver Wiseman More articles by this author , William FinchWilliam Finch More articles by this author , James ArmitageJames Armitage More articles by this author , Sarah FowlerSarah Fowler More articles by this author , John WithingtonJohn Withington More articles by this author , Jonathan GlassJonathan Glass More articles by this author , and Neil BurgessNeil Burgess More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.844AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES It is commonly believed that elderly octogenarian (>80 yrs) patients may not be offered PCNL because of the possible additional risks of major surgery associated with advanced age. We analyzed 4166 cases performed over a 2 year period and compared the stone complexity, complication rate and outcomes of the octogenarian patient (OP) compared to the younger patient (YP) aged under 80 years. METHODS The British Association of Urological Surgeons (BAUS) PCNL database has invited data submission for PCNL since 2011. We extracted data from the database for a 2 year period 2014-15. Comparisons were made using Chi Squared testing. RESULTS 4166 PCNL procedures performed between 01/01/2014 and 31/12/2015 were abstracted from the BAUS (British Association of Urological Surgeons) PCNL database. 172 procedures (4.1 %) were performed in OP who make up 4.9% of the UK population. M:F 84:88 , L:R:bilat = 88:83:1. BMI analysis revealed that fewer octogenarian patients were categorised as overweight or obese than the younger population (p< 0.05). There was no difference in the size or complexity of stone between the 2 group (p=0.68)) or stone dimension differences (<2cms vs >2cms) between the 2 populations. Complications both intraoperative (OP:YP, 22:314 p<0.05) and postoperative (OP:YP 21:285 p<0.05) were more common in the older patient group. However there was no difference comparing the incidence of Clavien Dindo (CD) 2 or less (OP:YP 14:188) to CD3b and above (OP:YP 7:92) between the 2 groups. Transfusion rates were commoner in the older age group (OP:YP 8:49 p<0.05) relating to more complex stones (GSS 3-4). Sepsis was not significantly more common in the older patient group by either stone size or complexity. Older patients length of stay (LOS) was significantly longer (5.06 vs 3.24 days 95%CI) for stones of lower complexity (GSS 1-2). There was no difference in LOS for more complex stones (GSS 3-4). There were no significant differences in stone clearance rates by stone complexity between the 2 groups either prior to discharge or at follow up. There were no differences in follow up rates between the 2 populations. CONCLUSIONS PCNL is a safe option for elderly patients. The outcomes were equivalent to younger patients. There were increased complications amongst the older patient group especially relating to transfusion associated with more complex stones. There was no difference in the serious complication rates between the 2 groups. Length of stay was significantly longer for older patients with less complex stones.There is no difference in stone free rates at follow up between the older and younger patient groups © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e351 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Stuart Irving More articles by this author Oliver Wiseman More articles by this author William Finch More articles by this author James Armitage More articles by this author Sarah Fowler More articles by this author John Withington More articles by this author Jonathan Glass More articles by this author Neil Burgess More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...