Pd28-10 outcomes of ureteroscopy for stone disease in extremely elderly patients (≥ 85 years): findings from a tertiary centre

You have accessJournal of UrologyCME1 Apr 2023PD28-10 OUTCOMES OF URETEROSCOPY FOR STONE DISEASE IN EXTREMELY ELDERLY PATIENTS (≥ 85 YEARS): FINDINGS FROM A TERTIARY CENTRE Patrick Juliebø-Jones, Christian Arvei Moen, Julie Nøss Haugland, Peder Gjengstø, Mathias Sørstrand Æsøy, Christian Beisland, and Øyvind Ulvik Patrick Juliebø-JonesPatrick Juliebø-Jones More articles by this author , Christian Arvei MoenChristian Arvei Moen More articles by this author , Julie Nøss HauglandJulie Nøss Haugland More articles by this author , Peder GjengstøPeder Gjengstø More articles by this author , Mathias Sørstrand ÆsøyMathias Sørstrand Æsøy More articles by this author , Christian BeislandChristian Beisland More articles by this author , and Øyvind UlvikØyvind Ulvik More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003313.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The volume of surgeries including ureteroscopy (URS) performed for urolithiasis is increasing. This includes for the elderly population. The aim of this study was to evaluate the outcomes of URS in extremely elderly patients and identify any lessons that could be learned for clinical practice and treatment planning. METHODS: Retrospective analysis was performed of consecutive patients aged 85 years and older undergoing URS between 2010-2022 at our tertiary centre. Uni- and multivariable logistic regression analysis was performed to identify possible risk factors for complications Survival analysis, stratified by age-adjusted Charlson Comorbidity index (ACCI), was performed using Kaplan-Meier method as well as the log-rank test. RESULTS: 64 URS procedures were performed on 51 patients (mean age 88, range 85-97). Mean ACCI score was 7 (range 4-13) and most patients were ASA 3 (78%). Mean operative time and hospital stay were 60 minutes (range 15-120) and 2 days (range 0-6), respectively. At 3 month follow up imaging, 92% were stone free (zero fragments). Intra-operative complication rate was 14% and in three cases (5%), early termination of the procedure was necessary. Eight patients (13%) suffered a complication prior to discharge. Eighteen patients (28%) had documented late complications after their surgery. The complication rate when combining early and late adverse events was 41%. One year mortality rate was 23%. Multivariable regression analysis revealed that operation time and ACCI>7 were significant predictors of complications after surgery. Survival probability was significantly worse in those patients with ACCI>7 (p=0.0083). CONCLUSIONS: The morbidity burden of URS in the extremely elderly is higher than for other population groups. Risk should be considered carefully and implementation of ACCI can aid this process. High scores should prompt strong consideration of a conservative approach. Operation time should be kept to a minimum wherever possible. Source of Funding: Nil © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e822 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Patrick Juliebø-Jones More articles by this author Christian Arvei Moen More articles by this author Julie Nøss Haugland More articles by this author Peder Gjengstø More articles by this author Mathias Sørstrand Æsøy More articles by this author Christian Beisland More articles by this author Øyvind Ulvik More articles by this author Expand All Advertisement PDF downloadLoading ...