Validation of a Questionnaire-Suitable Comorbidity Index in Patients Undergoing Radical Cystectomy

Area of Science:

• Urology
• Oncology
• Health Outcomes Research

Background:

• Radical cystectomy is a major surgery for bladder cancer.
• Accurate prediction of patient mortality is crucial for treatment planning and outcomes assessment.
• Existing comorbidity indices may require validation for specific surgical populations.

Purpose of the Study:

• To evaluate the predictive capability of a modified self-administrable comorbidity index from ICHOM for mortality after radical cystectomy.
• To compare its performance against the established Charlson score.

Main Methods:

• A single-center study included 1,337 patients undergoing radical cystectomy.
• Patients were stratified using the modified ICHOM index and Charlson score.
• Multivariate logit and proportional-hazards models analyzed 90-day and long-term mortality.

Main Results:

• Both indices independently predicted 90-day mortality when combined with age.
• The Charlson score showed a slightly higher AUC (0.74 vs. 0.72) for 90-day mortality.
• Performance for 5-year overall mortality was similar (AUC 0.63 vs. 0.62); the ICHOM index better separated risk groups.

Conclusions:

• The modified ICHOM comorbidity index demonstrates capability in predicting 90-day and long-term non-bladder cancer mortality post-radical cystectomy.
• Its predictive performance is comparable to the Charlson score.