title: Changing comorbidity classification patterns at radical prostatectomy during a 10-year period.
abstract: OBJECTIVE
  To investigate the consistency of several comorbidity classifications and concomitant diseases at radical prostatectomy (RP) during a 10-year period.
  
  
  METHODS
  In 1,297 patients who underwent RP between 1993 and 2002, age and several comorbidity classifications were derived from patient records and assigned to the year of surgery. Trends were evaluated using the Cochran-Armitage trend test.
  
  
  RESULTS
  Parallel to an increasing frequency of RPs and a shift toward more organ-confined tumors (P = 0.0094), the proportion of patients aged > or =70 years increased (P = 0.0077). The proportion of the American Society of Anesthesiologists (ASA) Physical Status class 3 increased (P < 0.0001), whereas that of ASA class 1 decreased (P < 0.0001). A Charlson score > or =1 has been assigned with an increasing frequency (P = 0.0008), whereas the trend with a Charlson score of > or =2 did not reach statistical significance (P = 0.07). In contrast to the latter 2 classifications, no significant trends were observed with classifications related to diabetes mellitus and heart disease.
  
  
  CONCLUSIONS
  This study shows that the application of the ASA classification may change significantly over time, whereas cardiac and diabetes-related conditions, as well as the Charlson score were apparently less sensitive to changing classification standards in the RP setting.
authors.affiliation: Department of Urology, University Hospital "Carl Gustav Carus," Technical University of Dresden, Dresden, Germany. Michael.Froehner@uniklinikum-dresden.de
authors.forename: Michael
authors.initials: M
authors.lastname: Froehner
authors.forename: Bernd
authors.initials: B
authors.lastname: Garbrecht
authors.forename: Oliver W
authors.initials: OW
authors.lastname: Hakenberg
authors.forename: Rainer
authors.initials: R
authors.lastname: Koch
authors.forename: Rainer J
authors.initials: RJ
authors.lastname: Litz
authors.forename: Sven
authors.initials: S
authors.lastname: Oehlschlaeger
authors.forename: Lars
authors.initials: L
authors.lastname: Twelker
authors.forename: Manfred P
authors.initials: MP
authors.lastname: Wirth
mesh_terms: D000368:Aged; D015897:Comorbidity; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000145:classification* / Q000453:epidemiology / Q000601:surgery