The PT2D-Score : a novel tool to predict complications and economic outcome after radical cystectomy
BACKGROUND: Radical cystectomy (RC) has a high morbidity and leads to a significant socio-economic burden. We aimed to investigate pre-, intra-, and post-operative variables to create a novel score predicting both post-operative clinical (complications) and economic (length of hospital stay) outcome after RC.
METHODS: We retrospectively evaluated clinical and histopathological data of 317 patients after RC. We performed univariate and multivariate logistic regression analyses to identify variables associated with post-operative clinical (30-day morbidity according to Clavien-Dindo complications) and economic (length of hospital stay) outcome.
RESULTS: In multivariate analysis, a high number of intraoperative transfusions (T) of packed red blood cells predicted major complications (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.10-2.58, p = 0.017), preoperative potassium (P) level predicted three or more complications (OR for high preoperative potassium 0.71, 95% CI 0.52-0.98, p = 0.037), and high drain (D) loss on post-operative day 1 predicted a longer hospital stay ≥ 22 days (OR 1.57, 95% CI 1.04-2.35, p = 0.003). The PT2D-Score was able to predict three or more complications (area under the curve: 0.70, 95% CI 0.61-0.78, p < 0.001) and a hospital stay of ≥ 22 days in patients after radical cystectomy (area under the curve: 0.63, 95% confidence interval 0.53-0.72, p = 0.012).
CONCLUSIONS: The novel PT2D-Score combines preoperative potassium level, intraoperative blood transfusion, and post-operative drain loss to predict both clinical (30-day morbidity) and economic (length of hospital stay) outcome for patients undergoing RC. After validation in a larger cohort, the novel PT2D-Score might serve as an additional criterion to identify patients for intensified monitoring after RC.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:38 |
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| Enthalten in: |
World journal of urology - 38(2020), 12 vom: 01. Dez., Seite 3155-3160 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kamal, M M [VerfasserIn] |
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| Links: |
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| Themen: |
Bladder cancer |
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| Anmerkungen: |
Date Completed 24.06.2021 Date Revised 24.06.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00345-020-03129-8 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM307154904 |
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| 100 | 1 | |a Kamal, M M |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The PT2D-Score |b a novel tool to predict complications and economic outcome after radical cystectomy |
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| 500 | |a Date Revised 24.06.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Radical cystectomy (RC) has a high morbidity and leads to a significant socio-economic burden. We aimed to investigate pre-, intra-, and post-operative variables to create a novel score predicting both post-operative clinical (complications) and economic (length of hospital stay) outcome after RC | ||
| 520 | |a METHODS: We retrospectively evaluated clinical and histopathological data of 317 patients after RC. We performed univariate and multivariate logistic regression analyses to identify variables associated with post-operative clinical (30-day morbidity according to Clavien-Dindo complications) and economic (length of hospital stay) outcome | ||
| 520 | |a RESULTS: In multivariate analysis, a high number of intraoperative transfusions (T) of packed red blood cells predicted major complications (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.10-2.58, p = 0.017), preoperative potassium (P) level predicted three or more complications (OR for high preoperative potassium 0.71, 95% CI 0.52-0.98, p = 0.037), and high drain (D) loss on post-operative day 1 predicted a longer hospital stay ≥ 22 days (OR 1.57, 95% CI 1.04-2.35, p = 0.003). The PT2D-Score was able to predict three or more complications (area under the curve: 0.70, 95% CI 0.61-0.78, p < 0.001) and a hospital stay of ≥ 22 days in patients after radical cystectomy (area under the curve: 0.63, 95% confidence interval 0.53-0.72, p = 0.012) | ||
| 520 | |a CONCLUSIONS: The novel PT2D-Score combines preoperative potassium level, intraoperative blood transfusion, and post-operative drain loss to predict both clinical (30-day morbidity) and economic (length of hospital stay) outcome for patients undergoing RC. After validation in a larger cohort, the novel PT2D-Score might serve as an additional criterion to identify patients for intensified monitoring after RC | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Bladder cancer | |
| 650 | 4 | |a Complications | |
| 650 | 4 | |a Cystoprostatectomy | |
| 650 | 4 | |a Economy | |
| 650 | 4 | |a Morbidity | |
| 650 | 4 | |a Urothelial carcinoma | |
| 650 | 7 | |a Potassium |2 NLM | |
| 650 | 7 | |a RWP5GA015D |2 NLM | |
| 700 | 1 | |a Borgmann, H |e verfasserin |4 aut | |
| 700 | 1 | |a Metzger, A |e verfasserin |4 aut | |
| 700 | 1 | |a Schregel, C |e verfasserin |4 aut | |
| 700 | 1 | |a Nabar, N D |e verfasserin |4 aut | |
| 700 | 1 | |a Haack, M |e verfasserin |4 aut | |
| 700 | 1 | |a Jäger, W |e verfasserin |4 aut | |
| 700 | 1 | |a Tsaur, I |e verfasserin |4 aut | |
| 700 | 1 | |a Haferkamp, A |e verfasserin |4 aut | |
| 700 | 1 | |a Höfner, T |e verfasserin |4 aut | |
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