The relationship of Charlson comorbidity index and postoperative complications in elderly patients after partial or radical nephrectomy

Objectives: To compare preoperative Charlson comorbidity Index (CCI) and postoperative complications after oncologic kidney surgery in patients aged 70 or older. To compare CCI and need for interdisciplinary evaluation, consults to the emergency department and need of readmission are secondary objectives.Patients and methods: This is a retrospective cohort study. Patients aged 70 or older who underwent partial or radical nephrectomy were collected from an institutional database. Period: February 2012–June 2014. Association between CCI and complications was estimated using Chi2.Results: Final population: 143 (male: 65%). Age median was 75. Minor postoperative complications were 33.88% (n = 41) for patients CCI ≤ 4 versus 9.09% (n = 2) for patients CCI > 4 (p > 0.05), and major postoperative complications were 9.91% (n = 12) versus 45.45% (n = 10), respectively (p < 0.01). Interdisciplinary evaluation was required for 30.6% (n = 37) of patients CCI ≤ 4 versus 59% (n = 13) of patients CCI > 4 (p = 0.01). Readmission was needed for 9.09% (n = 11) and 40.1% (n = 11) respectively (p < 0.01).Conclusions: Patients with high comorbidity presented more major postoperative complications. These patients also required more interdisciplinary evaluation after surgery. A higher CCI was not associated with further consults to the emergency department or readmission

AA amyloidosis. A single institution cohort study.

There is limited epidemiological information on AA amyloidosis in Argentina, so the objective of this study was to describe the epidemiological characteristics of this disease in a tertiary hospital in our country. We designed a prospective clinical cohort of all consecutive patients with AA amyloidosis confirmed by immunohistochemistry in tissue from the Institutional Registry of Amyloidosis of the Hospital Italiano de Buenos Aires, in the period 04/01/2012- 12/31/2017. Of the 121 patients in the registry, 18 were included with AA for the analysis. Of the total included, 50% (9) were female, with a median age of 53.5 (interquartile range, RII 46-61) years. The 88.9% (16) of cohort presented renal compromise, all had proteinuria, and 6 required dialysis. Six had amyloid infiltration of the digestive system. The latency between the onset of the underlying disease and the diagnosis of AA had a median of 27 (RII 8-35) years. The underlying disease was of inflammatory origin in 6 cases. In 50% (9) of the patients the cause of AA amyloidosis was unknown. In the remaining 50%, these causes resemble those observed in developed countries. Furthermore, our results highlight the importance of their differential diagnosis to identify the most appropriate treatment or follow-up according to the situation presented by each patient