Abstract: PD16-10
Sources of Funding: None

Introduction

It is commonly believed that elderly octogenarian (>80 yrs) patients may not be offered PCNL because of the possible additional risks of major surgery associated with advanced age. We analyzed 4166 cases performed over a 2 year period and compared the stone complexity, complication rate and outcomes of the octogenarian patient (OP) compared to the younger patient (YP) aged under 80 years._x000D_

Methods

The British Association of Urological Surgeons (BAUS) PCNL database has invited data submission for PCNL since 2011. We extracted data from the database for a 2 year period 2014-15. _x000D_ _x000D_ Comparisons were made using Chi Squared testing

Results

4166 PCNL procedures performed between 01/01/2014 and 31/12/2015 were abstracted from the BAUS (British Association of Urological Surgeons) PCNL database. _x000D_ 172 procedures (4.1 %) were performed in OP who make up 4.9% of the UK population. M:F 84:88 , L:R:bilat = 88:83:1. BMI analysis revealed that fewer octogenarian patients were categorised as overweight or obese than the younger population (p< 0.05)_x000D_ _x000D_ There was no difference in the size or complexity of stone between the 2 group (p=0.68)) or stone dimension differences (<2cms vs >2cms) between the 2 populations._x000D_ _x000D_ Complications both intraoperative (OP:YP, 22:314 p<0.05) and postoperative (OP:YP 21:285 p<0.05) were more common in the older patient group. However there was no difference comparing the incidence of Clavien Dindo (CD) 2 or less (OP:YP 14:188) to CD3b and above (OP:YP 7:92)between the 2 groups. Transfusion rates were commoner in the older age group (OP:YP 8:49 p<0.05) relating to more complex stones (GSS 3-4). Sepsis was not significantly more common in the older patient group by either stone size or complexity. _x000D_ _x000D_ Older patients length of stay (LOS) was significantly longer (5.06 vs 3.24 days 95%CI) for stones of lower complexity (GSS 1-2). There was no difference in LOS for more complex stones (GSS 3-4)._x000D_ _x000D_ There were no significant differences in stone clearance rates by stone complexity between the 2 groups either prior to discharge or at follow up._x000D_ There were no differences in follow up rates between the 2 populations._x000D_

Conclusions

PCNL is a safe option for elderly patients. The outcomes were equivalent to younger patients. There were increased complications amongst the older patient group especially relating to transfusion associated with more complex stones. There was no difference in the serious complication rates between the 2 groups. Length of stay was significantly longer for older patients with less complex stones._x000D_ There is no difference in stone free rates at follow up between the older and younger patient groups

Funding

None