Safety and efficacy of retrograde intrarenal surgery in geriatric patients by age groups
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UROLOGY - ORIGINAL PAPER
Safety and efficacy of retrograde intrarenal surgery in geriatric patients by age groups Aykut Aykac1 · Ozer Baran1 Received: 27 April 2020 / Accepted: 6 July 2020 © Springer Nature B.V. 2020
Abstract Purpose To evaluate the effects of aging on the success rate of retrograde intrarenal surgery (RIRS) and the development of medical and surgical complications by dividing geriatric patients into subgroups based on their chronological age. Method Data of the patients who underwent RIRS due to kidney stones at our clinic between June 2014 and January 2020 were retrospectively reviewed. Patients were divided into three groups based on age: 65–74 years (Group 1), 75–84 years (Group 2), and ≥ 85 years (Group 3). The comorbid diseases of patients were evaluated using the Charlson Comorbidity Index (CCI), total Cumulative Illness Rating Scale for Geriatrics (CIRS-G) score, and CIRS severity index (CIRS-G SI). RIRS success rates and complications were evaluated based on age groups. Results A total of 336 patients were included in the study. The mean age of the patients was 72.7 ± 6.59 years. Stone-free rate was 81.5% in patients aged > 65 years and did not change with age. The modified Clavien–Dindo grade I/II complication rates for surgical complications were similar in all three groups (p = 0.818). In the evaluation of ROC analysis for medical complications, it was observed that the cut-off values were 76.5 years, CIRS-G score of 4.5, CCI score of 2.5, and CIRS-SI score of 1.18 (p 65 years [3]. The European urology guidelines recommend shock wave lithotripsy and retrograde intrarenal surgery (RIRS) as surgical treatment options for kidney stones ( 65 years; these patients should be separately considered for comparison. The present study aimed to evaluate the effects of aging on the success rate of RIRS as well as on the development of medical and surgical complications by dividing geriatric patients into subgroups based on their chronological age.
Materials and methods The study was designed in compliance with the Declaration of Helsinki and was approved by the Local Ethics Committee of Karabuk University (dated 11/11/2019, number 7/41). The data of patients who underwent RIRS due to kidney stones or proximal ureteral stones at our clinic between June 2014 and January 2020 were retrospectively reviewed. The inclusion criterion was patients aged > 65 years at the time of surgery. The patients were divided into three groups based on age: 65–74 years (Group 1), 75–84 years (Group 2), and ≥ 85 years (Group 3). The demographic data, current medical diseases according to International Classification of Diseases (ICD-10) codes, American Society of Anesthesiologists (ASA) scores, used medications, and physical examination findings of the patients were obtained from the hospital web-based data system and analyzed. Serum creatinine level measurement, complete blood count, coagulation tests, electrocardiography, chest X-ray, and urine culture tests were performed for all patients prior to surgery. Ot
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