Clinical Validation of the Comprehensive Complication Index in Colon Cancer Surgery

Simple Summary The results of this study showed a greater ability of the Comprehensive Complication Index if compared to the conventional Clavien-Dindo classification to predict hospital stay in colon cancer patients, particularly in patients with multiple postoperative complications. These results encourage the routine use of the Comprehensive Complication Index to grade postoperative complications in colonic surgery. (1) Introduction: To date, the sensitivity of the Comprehensive Complication Index (CCI) in a homogeneous cohort of colonic resections for oncologic purposes has not been reported. The present study aims to compare the CCI with the conventional Clavien-Dindo classification (CDC) in colon cancer patients. (2) Methods: The clinical data of patients submitted to an elective colectomy for adenocarcinoma were retrieved from a prospectively maintained database. Postoperative complications and length of stay were reviewed, and CDC and CCI scores were calculated for each patient. The association of the CCI and the CDC with the length of stay, prolongation of stay and readmission rate were assessed and compared. (3) Results: The overall postoperative morbidity was 26.9%. In particular, 157 (20.4%) patients had more than one complication. A strong correlation between the two scoring systems was observed (r = 99.4%; 95%CI: 99.3-99.5%). In multivariate analysis, CCI had a higher predictive ability for all endpoints. Regarding subgroup analysis, the difference between the CCI and CDC was progressively increased when evaluating outcome measures in complicated and multi-complicated patients. (4) Conclusion: Both scoring systems adequately report the overall burden of postoperative complications. The CCI showed a greater ability than the CDC to predict hospital stay, particularly in patients with multiple postoperative complications.

Automated summary

The study showed that the Comprehensive Complication Index (CCI) is more effective than the Clavien-Dindo classification in predicting hospital stay for colon cancer patients, especially those with multiple postoperative complications. These findings support the routine use of CCI in grading postoperative complications in colonic surgery.