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Updated: Jun 4, 2025
Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
Association between the age-adjusted Charlson Comorbidity Index and complications after kidney transplantation: a
Qin Huang1, Tongsen Luo1, Jirong Yang1
1Department of Anesthesiology, Guangdong Province, The Third Affiliated Hospital of Sun Yat-Sen University, No. 600 Tianhe Road, Guangzhou, 510630, China.
Insights
A higher age-adjusted Charlson Comorbidity Index (ACCI) score in kidney transplant (KT) recipients indicates an increased risk of postoperative complications. Preoperative ACCI exceeding 3 is a significant predictor of adverse outcomes post-transplant.
Area of Science:
- Nephrology
- Transplant Surgery
- Medical Statistics
Background:
- Post-kidney transplant complications significantly increase readmission and mortality risks.
- Assessing preoperative factors is crucial for mitigating adverse events in kidney transplant recipients.
Purpose of the Study:
- To evaluate the association between the age-adjusted Charlson Comorbidity Index (ACCI) and postoperative complications in kidney transplant (KT) recipients.
- To identify specific comorbidities contributing to increased complication risk post-KT.
Main Methods:
- A cohort study of 886 KT recipients (2015-2021) at a single center.
- Postoperative complications were classified using the Clavien-Dindo system.
- Target Maximum Likelihood Estimation (TMLE) and multivariable analysis assessed the ACCI-complication relationship.
Main Results:
- 30.7% of the 859 included KT recipients experienced postoperative complications.
- An ACCI score >3 was significantly associated with increased postoperative complications (aOR=1.64, p=0.001).
- Congestive heart failure, peripheral vascular disease, and COPD were key comorbidities linked to complications.
Conclusions:
- Preoperative ACCI >3 is a significant risk factor for postoperative complications in KT patients.
- Identifying high-risk patients via ACCI allows for targeted interventions to improve transplant outcomes.
Background:
Complications following kidney transplantation elevate the risks of readmission and mortality. The aim of this study was to assess the association between the age-adjusted Charlson Comorbidity Index (ACCI) and postoperative complications among kidney transplant (KT) recipients.
Methods:
Between January 2015 and March 2021, a study involving 886 kidney transplant recipients at the Third Affiliated Hospital of Sun Yat-sen University was conducted. Postoperative complications were defined by the Clavien-Dindo Classification of Surgical Complications. Target Maximum Likelihood Estimation (TMLE) was employed to assess the association between ACCI and postoperative complications. The odds ratio (OR) was computed to determine the relationship between ACCI and postoperative complications. Subsequent interaction and stratified analyses were performed to assess the robustness of the findings.
Results:
Out of 859 KT participants ultimately included in the study, 30.7% were documented to have encountered postoperative complications. Participants with an ACCI value exceeding 3 exhibited a notably increased risk of postoperative complications following multivariable adjustment [aOR = 1.64, 95% CI [1.21,2.21], p = 0.001]. Congestive heart failure (OR = 16.18, 95% CI [1.98-132.17], p < 0.001), peripheral vascular disease (OR = 2.32, 95% CI [1.48-3.78], p < 0.001), and chronic obstructive pulmonary disease (OR = 6.05, 95% CI [2.95-12.39], p < 0.001) emerged as the top three preoperative comorbidities significantly linked to postoperative complications in ACCI.
Conclusion:
An ACCI value exceeding 3 preoperatively constituted a risk factor for postoperative complications among KT patients.
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