title: Correlation of ASA Grade and the Charlson Comorbidity Index With Complications in Patients After Transurethral Resection of Prostate.
abstract: OBJECTIVE
  To re-assess the Charlson Comorbidity Index (CCI) and the American Society of Anesthesiologists Physical Status Classification System (ASA grade) as predictive factors of complications after transurethral resection of prostate.
  
  
  METHODS
  This study retrospectively included and analyzed consecutive patients undergoing transurethral resection of the prostate at Peking University First Hospital between 1992 and 2013. A multivariate analysis was conducted to evaluate the connection of the ASA and CCI grades with the incidence of complications.
  
  
  RESULTS
  This paper studied 2326 cases in total. The CCI and ASA grades were significantly correlated, with a Spearman ρ of 0.245 (P <.001). No considerable differences among the patient cohorts with different CCI or ASA grades were observed in terms of day of catheter removal, surgical time, and prostate size. In addition, no considerable differences were observed in the different modified Clavien classification system scores of complications among patient cohorts with different grades of CCI.
  
  
  CONCLUSIONS
  The majority of complications (86.9%) were of grades I, II, and III, whereas grade IV was less frequent (12.1%), and, after transurethral resection of the prostate, grade V was rare (1%). Males with an ASA grade ≥3 and higher CCI scores were more likely to demonstrate a higher incidence of morbidity than males with a lower grade. However, ASA grades and CCI scores were not independent predictors of complications because of the experience of the surgeon and progress in perioperative management and operative techniques. Therefore, for patients with more comorbidities and higher CCI scores or ASA grades, active surgical intervention is still suggested.
authors.affiliation: Department of Urology, Peking University First Hospital and Institute of Urology, National Research Center for Genitourinary Oncology, Beijing, China.
authors.forename: Runqi
authors.initials: R
authors.lastname: Guo
authors.affiliation: Department of Urology, Peking University First Hospital and Institute of Urology, National Research Center for Genitourinary Oncology, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Yu
authors.affiliation: Department of Urology, Peking University First Hospital and Institute of Urology, National Research Center for Genitourinary Oncology, Beijing, China.
authors.forename: Yisen
authors.initials: Y
authors.lastname: Meng
authors.affiliation: Department of Urology, Peking University First Hospital and Institute of Urology, National Research Center for Genitourinary Oncology, Beijing, China. Electronic address: kaizhangpku@163.com.
authors.forename: Kai
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Urology, Peking University First Hospital and Institute of Urology, National Research Center for Genitourinary Oncology, Beijing, China.
authors.forename: Ben
authors.initials: B
authors.lastname: Xu
authors.affiliation: Department of Urology, Peking University First Hospital and Institute of Urology, National Research Center for Genitourinary Oncology, Beijing, China.
authors.forename: Yunxiang
authors.initials: Y
authors.lastname: Xiao
authors.affiliation: Department of Urology, Peking University First Hospital and Institute of Urology, National Research Center for Genitourinary Oncology, Beijing, China.
authors.forename: Shiliang
authors.initials: S
authors.lastname: Wu
authors.affiliation: Department of Urology, Peking University First Hospital and Institute of Urology, National Research Center for Genitourinary Oncology, Beijing, China.
authors.forename: Bainian
authors.initials: B
authors.lastname: Pan
mesh_terms: D000368:Aged; D015897:Comorbidity / Q000639:trends; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D011379:Prognosis; D011467:Prostate / Q000473:pathology* / Q000601:surgery; D011469:Prostatic Diseases / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D020728:Transurethral Resection of Prostate / Q000009:adverse effects*