title: Prospective comparison of outcomes of percutaneous nephrolithotomy in elderly patients versus younger patients.
abstract: OBJECTIVE
  The purpose of the study was to prospectively compare operative and postoperative characteristics and outcomes in elderly patients undergoing percutaneous nephrolithotomy (PCNL) compared with younger patients.
  
  
  METHODS
  Prospectively collected data from the Clinical Research Office of the Endourological Society (CROES) Global PCNL Study database were used. Elderly patients were defined as those aged 70 years and above, while younger patients were those between 18 and 70 years of age. Matched and unmatched group comparisons were performed based on imaging modality used for assessing stone-free status. Patient characteristics, operative data, and postoperative outcomes were compared.
  
  
  RESULTS
  The median age of the elderly group vs the young group was 74 years (range 70-93 years) vs 49 years. In the unmatched analysis, staghorn stones were seen at higher rates in the elderly group (27.8% vs 21.8%, P=0.014); however, the mean stone size was not significantly different (465.0 vs 422.8, P=0.063). The length of hospitalization was significantly longer in the elderly group compared with the young group in the unmatched analysis (5 days vs 4.1 days, P<0.001). The same difference was not apparent in the matched analysis (5.0 days vs 4.4 days, P=0.288). Overall complication rates were not significantly different in the unmatched analysis. In the matched analysis, however, a statistically significant higher rate of overall complications was seen. Stone-free rates were similar among all groups.
  
  
  CONCLUSIONS
  PCNL in elderly patients over the age of 70 years produces results comparable to those seen in younger patients. With only a slightly higher-be it statistically significant-complication rate, the stone-free rate in older patients was the same as in the younger group.
authors.affiliation: Arthur Smith Institute for Urology, North Shore-Long Island Jewish Health System, New York, New York, USA.
authors.forename: Zeph
authors.initials: Z
authors.lastname: Okeke
authors.forename: Arthur D
authors.initials: AD
authors.lastname: Smith
authors.forename: Gaston
authors.initials: G
authors.lastname: Labate
authors.forename: Alessandro
authors.initials: A
authors.lastname: D'Addessi
authors.forename: Ramakrishna
authors.initials: R
authors.lastname: Venkatesh
authors.forename: Dean
authors.initials: D
authors.lastname: Assimos
authors.forename: Willem E M
authors.initials: WE
authors.lastname: Strijbos
authors.forename: Jean J M C H
authors.initials: JJ
authors.lastname: de la Rosette
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003710:Demography; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D011182:Postoperative Care; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult